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Limitations of maintenance therapy for viral respiratory infection-induced asthma

Iolo J M Doull1

  • 1Cystic Fibrosis/Respiratory Unit, Department of Child Health, University Hospital of Wales, Cardiff, Wales. doullij@:cf.ac.uk

The Journal of Pediatrics
|February 14, 2003
PubMed

Insights

Maintenance therapy for persistent asthma in children, particularly inhaled corticosteroids, significantly reduces exacerbations and healthcare visits. This treatment is not effective for children with intermittent wheezing due to viral infections without persistent symptoms.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Pharmacotherapy

Background:

  • Asthma exacerbations pose significant risks to children's health and well-being.
  • Effective maintenance therapies are crucial for managing persistent childhood asthma.
  • Identifying appropriate treatment strategies for different asthma phenotypes is essential.

Purpose of the Study:

  • To evaluate the effectiveness of maintenance therapies in reducing asthma exacerbations in children.
  • To compare the benefits of nedocromil sodium, inhaled corticosteroids, and montelukast.
  • To determine the impact of these therapies on healthcare utilization and oral corticosteroid rescue needs.

Main Methods:

  • Retrospective analysis of treatment outcomes in asthmatic children.
  • Comparison of exacerbation rates across different maintenance therapy groups.
  • Assessment of healthcare visits and oral corticosteroid use.

Main Results:

  • Maintenance therapy with nedocromil sodium, inhaled corticosteroids, or montelukast decreased asthma exacerbations in children with persistent symptoms.
  • Inhaled corticosteroids provided the greatest benefit, reducing exacerbations, oral corticosteroid needs, urgent visits, and hospitalizations by approximately 50% in preschool- and school-aged children.
  • Maintenance therapy showed no benefit in children with intermittent virus-induced wheezing without persistent symptoms.

Conclusions:

  • Regular inhaled corticosteroids are highly effective for managing persistent asthma in children.
  • Nedocromil sodium and montelukast also offer benefits for persistent asthma.
  • Maintenance therapy is not indicated for children with intermittent viral wheezing and no persistent symptoms.

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