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Lung function at 10 yrs is not improved by early corticosteroid treatment in asthmatic children

Karin C Lødrup Carlsen1, Chandra Sekhar Devulapalli, Petter Mowinckel

  • 1Department of Paediatrics, Division of Woman and Child, Oslo University Hospital, Ullevål, Oslo, Norway. k.c.l.carlsen@medisin.uio.no

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|November 17, 2009
PubMed

Insights

Early inhaled corticosteroid (ICS) treatment did not significantly improve childhood lung function development up to age 10. Lung function at birth and gender were key factors influencing lung health outcomes.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Childhood Asthma Research

Background:

  • The impact of early inhaled corticosteroid (ICS) treatment on lung function development in children remains a subject of debate.
  • Lung function trajectories in childhood are influenced by various factors, necessitating investigation into early therapeutic interventions.

Purpose of the Study:

  • To evaluate whether early initiation of ICS treatment influences lung function at 10 years of age.
  • To assess the relationship between ICS use and lung function parameters in children from birth to age 10.

Main Methods:

  • A 10-year follow-up study involving 614 children with birth lung function data from the "Environment and Childhood Asthma" study in Oslo.
  • Collected data on ICS treatment history at ages 2 and 10 years via parental interviews.
  • Analyzed lung function outcomes, including forced expiratory volume in 1 second (FEV1) and mid-expiratory flow, and correlated them with ICS use and birth lung function parameters (t(PTEF)/t(E)).

Main Results:

  • ICS treatment, reported by 11.9% of the cohort and 71.6% of those with current asthma, did not significantly impact lung function development from birth to age 10.
  • No significant differences in FEV1 or mid-expiratory flow Z-scores were observed between children who received ICS treatment (at various timings) and those who never used steroids.
  • Gender, a history of asthma, and tidal flow-volume ratio at birth were significant predictors of lung function changes over the 10-year period.

Conclusions:

  • Early intervention with ICS for childhood asthma did not demonstrate a significant benefit on lung function development up to 10 years of age.
  • Factors such as birth lung function and gender play a more substantial role in determining lung function trajectories than early ICS use.
  • The findings suggest a need to re-evaluate current guidelines regarding the timing and impact of early ICS treatment on long-term pediatric lung health.

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