Study questions use of extra steroids

Amping up steroid dosage for children with asthma doesn’t effectively prevent severe flareups, and may even interfere with a child’s growth, according to new research from the National Institutes of Health.

The study, funded by the National Heart, Lung and Blood Institute, part of the National Institutes of Health, appears online in the New England Journal of Medicine.

According to the state Department of Public Health, in 2014, (the most recent year for which numbers were available) 72,000 (9.6 percent) children and 257,000 (9.2 percent) adults in Connecticut suffered from asthma. In 2014, 8.6 percent of U.S. children and 7.4 percent of U.S. adults had asthma.

Asthma flare-ups in children are common and costly, and to prevent them many health professionals recommend increasing the doses of inhaled steroids at early signs of symptoms, such as coughing, wheezing, and shortness of breath.

Until now, researchers had not rigorously tested how safe and effective this strategy is in children with mild-to-moderate asthma.

“These findings suggest that a short-term increase to high-dose inhaled steroids should not be routinely included in asthma treatment plans for children with mild-moderate asthma who are regularly using low-dose inhaled corticosteroids,” said study leader Dr. Daniel Jackson, associate

Though the (asthmatic) children in the high-dose group had 14 percent more exposure to inhaled steroids than the low-dose group, they did not experience fewer severe flare-ups.

professor of pediatrics at the University of Wisconsin School of Medicine and Public Health, Madison, and an expert on childhood asthma said in a news release.

“Low-dose inhaled steroids remain the cornerstone of daily treatment in affected children.”

According to a release from the NIH, the research team studied 254 children 5 to 11 years of age with mild-to-moderate asthma for nearly a year. All the children were treated with low-dose inhaled corticosteroids (two puffs from an inhaler twice daily).

At the earliest signs of asthma flare-up, which some children experienced multiple times throughout the year, the researchers continued giving low-dose inhaled steroids to half of the children and increased to highdose inhaled steroids (five times the standard dose) in the other half, twice daily for seven days during each episode.

Though the children in the high-dose group had 14 percent more exposure to inhaled steroids than the low-dose group, they did not experience fewer severe flareups.

The number of asthma symptoms, the length of time until the first severe flare-up, and the use of albuterol (a drug used as a rescue medication for asthma symptoms) were similar between the two groups.

Researchers also found that the rate of growth of children in the short-term high-dose strategy group was about 0.23 centimeters per year less than the rate for children in the low-dose strategy group, even though the high-dose treatments were given only about two weeks per year on average.

The study did not include children with asthma who do not take inhaled steroids regularly, nor did it include adults.