Increasing medication 4-fold may not mitigate pediatric asthma attacks

A study published in The New England Journal of Medicine examined the safety and efficacy of increasing the doses of inhaled glucocorticoids for children experiencing asthma attacks.

Researchers studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma. They also had at least one asthma exacerbation, or attack, treated with systemic glucocorticoids in the previous year.

For the study, children were randomly assigned to receive low-dose inhaled glucocorticoids or use a quintupled dose for seven days at the early signs of loss of asthma control.

The study shows rate of severe asthma exacerbations treated with systemic glucocorticoids did not differ significantly between the two groups. Additionally, the following factors did not differ between the groups:

• Time to the first exacerbation
• Rate of treatment failure
• Symptom scores
• Albuterol use during yellow-zone episodes

Researchers found the total glucocorticoid exposure was 16 percent higher in the high-dose group as compared to the low-dose group.

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