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Early intervention with suplatast tosilate for prophylaxis of pediatric atopic asthma: a pilot study

Shigemi Yoshihara1, Mika Ono, Yumi Yamada

  • 1Department of Pediatrics, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan. shigemi@dokkyomed.ac.jp

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|February 13, 2009
PubMed

Insights

Early intervention with suplatast tosilate, a Th2 cytokine inhibitor, significantly reduced asthma incidence in infants with food allergies and atopic dermatitis compared to ketotifen. This suggests suplatast tosilate is effective for preventing childhood asthma.

Area of Science:

  • Pediatrics
  • Immunology
  • Allergy & Immunology

Background:

  • Infant asthma onset may link to Th2 cytokine dominance during food allergy development.
  • Early intervention strategies are crucial for preventing allergic diseases in infants.

Purpose of the Study:

  • To investigate the efficacy of suplatast tosilate, a Th2 cytokine inhibitor, for preventing asthma in infants with food allergies and atopic dermatitis.
  • To compare suplatast tosilate with ketotifen fumarate, a histamine H1-blocker, in asthma prevention.

Main Methods:

  • A randomized pilot study involving 53 infants with food allergy-induced atopic dermatitis.
  • Treatment groups received either suplatast tosilate (6 mg/kg/day) or ketotifen fumarate (0.06 mg/kg/day) for 24 months.
  • Primary endpoints included asthma incidence and time to wheezing onset; secondary measures included Th1/Th2 ratio, IgE, and eosinophil counts.

Main Results:

  • Asthma prevalence was significantly lower in the suplatast group (20.8%) versus the ketotifen group (65.6%) after 24 months (p < 0.01).
  • The time to initial wheezing episode was significantly longer in the suplatast group for infants who developed asthma (p < 0.01).
  • Suplatast treatment significantly decreased eosinophil counts (p < 0.05) and showed significant differences in eosinophil counts (p < 0.01) and Th1/Th2 ratio (p < 0.05) compared to ketotifen.

Conclusions:

  • Suplatast tosilate demonstrates potential as a prophylactic treatment for wheezing and asthma in high-risk infants.
  • Early Th2 cytokine inhibition may be a viable strategy for preventing asthma development in infants with allergic conditions.

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