Reactions 669 - 20 Sep 1997

Recommendations for inhaledcorticosteroids in children

Limiting maintenance doses of inhaled corticosteroidsto 400–500 µg/day and avoiding a combination ofinhaled and oral corticosteroids can reduce the adverseeffects of such therapy in asthmatic children, accordingto Dr Jeffrey Wagener of Children’s Hospital in Denver,Colorado, US.

Dr Wagener reports that new asthma guidelinesrecommend for the first time that inhaledcorticosteroids be considered in difficult patients aged< 5 years and as a first-line therapy for children aged >5 years. He thus stresses the importance of limitingpotential corticosteroid-induced adverse effects inpaediatric patients. Dr Wagener recommends startingwith high dosages then reducing to the minimumrequired for asthma control (if possible < 400–500µg/day). He also recommends combining inhaledcorticosteroids with long-acting bronchodilators whennecessary, and encourages the use of a spacer device.

Because of the possibility of cataracts and othersystemic effects such as growth delay, Dr Wagenerstresses the importance of monitoring children duringinhaled corticosteroid therapy. He notes thatcorticosteroid-related adverse effects in children withasthma are very unusual if there is no evidence ofgrowth delay, and recommends checking the growthcurve of children every 3 months during therapy.Limiting inhaled steroid dose curbs side effects in pediatric asthma. Reuters Health[online] : [1 page], 10 Sep 1997. Available from: URL: http://www.reutershealth.com 800613555

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Reactions 20 Sep 1997 No. 6690114-9954/10/0669-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved