title: Benefits and Risks of Long-Term Asthma Management in Children: Where Are We Heading?
abstract: International guidelines provide recommendations for a stepwise approach to the management of asthma in children 0-4 years old, 5-11 years old, and adolescents who are treated as adults. Therapy is aimed at two domains of control: current impairment and future risk. The long-term controller medications, inhaled corticosteroids (ICSs), ICSs in combination with long-acting β2agonists, leukotriene receptor antagonists, and immunomodulators, exhibit different efficacies for these domains. The risk:benefit ratios of the available medications need to be carefully assessed. This review briefly presents the benefits and the potential risks of available asthma medications in children to assist the practitioner in the optimal use of asthma medications. Specifically, the systemic activity of the ICSs and how to minimize their effects on growth and adrenal activity are reviewed as well as other potential adverse effects. Dosing strategies such as intermittent therapy are also assessed.
authors.affiliation: Department of Pediatrics, MSC10 5590, University of New Mexico, School of Medicine, 1 University of New Mexico, Albuquerque, NM, 87131, USA. HRaissy@salud.unm.edu.
authors.forename: Hengameh H
authors.initials: HH
authors.lastname: Raissy
authors.affiliation: Department of Pediatrics, MSC10 5590, University of New Mexico, School of Medicine, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
authors.forename: H William
authors.initials: HW
authors.lastname: Kelly
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic; D013997:Time Factors
chemical_list: D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids