Evidence Supports Intermittent ICS to Prevent Wheeze Exacerbations in Preschoolers

Findings for preschool children with intermittent asthma or viral-triggered wheezing
Findings for preschool children with intermittent asthma or viral-triggered wheezing

HealthDay News — There is strong evidence to support intermittent inhaled corticosteroids (ICS) for prevention of wheeze exacerbations in preschool children with intermittent asthma or viral-triggered wheezing, according to a review published online May 26 in Pediatrics.

Sunitha Kaiser, MD, of the University of California, San Francisco, and colleagues analyzed 22 studies involving 4,550 children age 6 and younger. All had at least two episodes of asthma or wheezing in the previous year.

In 15 of the studies, children with persistent asthma or wheezing had a 30% reduction in the risk of exacerbation with daily medium-dose ICS use. Five other studies focused on more sporadic use of the inhalers by children whose wheezing was not persistent, and was typically only spurred by a cold. Those studies found a 35% reduction in exacerbations with high-dose intermittent ICS use compared to a placebo. Two more studies compared the effects of daily ICS and more sporadic ICS use in children with wheezing induced by common colds. Those studies found no difference in the number of exacerbations. There were no studies that compared daily-versus-intermittent use of ICS for children with chronic, daily asthma or wheeze.

"There is strong evidence to support daily ICS for preventing exacerbations in preschool children with recurrent wheeze, specifically in children with persistent asthma," the authors conclude. "For preschool children with intermittent asthma or viral-triggered wheezing, there is strong evidence to support intermittent ICS for preventing exacerbations."

Two authors disclosed financial ties to the pharmaceutical industry.

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