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[Inhaled corticosteroids in the treatment of childhood asthma]
M Albertini1, D Lazartigues, S Politano
1Clinique Médicale Infantile, Hôpital de Cimiez, Nice.
Insights
Inhaled corticosteroids are effective for childhood asthma management, offering improved long-term outcomes with minimal side effects compared to oral steroids. Optimal delivery via spacers ensures efficacy and safety in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Allergy and Immunology
Context:
- Inhaled corticosteroids (ICS) are increasingly utilized for childhood asthma prophylaxis.
- Advancements in ICS potency allow for high-dose use in severe asthma, avoiding long-term oral corticosteroid therapy.
Purpose:
- To review the role and efficacy of inhaled corticosteroids in managing childhood asthma.
- To highlight optimal drug delivery methods and potential side effects.
Summary:
- High potency inhaled corticosteroids, delivered via large volume spacers for optimal pulmonary deposition, effectively manage severe childhood asthma.
- These treatments improve clinical condition, pulmonary function, and long-term asthma prognosis by reducing airway inflammation and hyperreactivity.
- While generally safe at usual doses, high-dose, long-term ICS use requires monitoring of adrenal function and growth.
Impact:
- Inhaled corticosteroids offer a safer alternative to long-term oral corticosteroids for severe pediatric asthma.
- Improved asthma control and reduced airway inflammation may lead to better long-term health outcomes for children.
- This therapeutic approach supports the reduction of chronic airway inflammation and bronchial hyperreactivity in pediatric asthma patients.
Abstract:
During the last fifteen years, inhaled corticosteroids were increasingly used for prophylaxis in childhood asthma. The development of inhaled corticosteroids with a high ratio of topical vs systemic potency, now makes possible their use in large doses which are needed to control the most severe forms of the disease, in order to avoid long term oral corticosteroid treatment for these patients. The efficacy of inhaled corticosteroids depends on an optimal pulmonary deposition of the drug which is obtained with children by inhaling the drug via a large volume spacer. Beyond their beneficial effects on the clinical condition of the patients and on pulmonary function, inhaled corticosteroids should improve the long term prognosis of asthma, by reducing chronic inflammation in the airways and the associated bronchial hyperreactivity. At usual dosages, inhaled corticosteroids are free of harmful side effects. However, caution and close observation of adrenal function and growth development are required when prescribing inhaled corticosteroids at high dosages for a long period. Nevertheless, inhaled corticosteroids present very few serious side effects compared with those induced by long term oral corticosteroid treatment.