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Inhaled corticosteroids in childhood asthma: the story continues

Wim M C van Aalderen1, Aline B Sprikkelman

  • 1Department of Paediatric Respiratory Medicine and Allergy, Emma Children's Hospital AMC, Amsterdam, The Netherlands, w.m.vanaalderen@amc.nl

European Journal of Pediatrics
|October 9, 2010
PubMed

Insights

Inhaled corticosteroids (ICS) are effective for persistent childhood asthma, reducing symptoms and exacerbations. Their use in preschool wheeze is being studied, with potential benefits in specific phenotypes and reassurance on safety.

Area of Science:

  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Inhaled corticosteroids (ICS) are the primary anti-inflammatory treatment for persistent childhood asthma.
  • ICS significantly reduce asthma-related mortality, morbidity, symptoms, and exacerbations.
  • The efficacy of ICS in preschool wheeze remains debated, with distinct phenotypes identified.

Purpose of the Study:

  • To review the efficacy and safety of inhaled corticosteroids (ICS) in children with asthma and preschool wheeze.
  • To discuss the potential benefits of small particle ICS in young children.
  • To evaluate the safety profile of ICS concerning systemic effects in different pediatric age groups.

Main Methods:

  • Literature review of existing studies on ICS in pediatric asthma and preschool wheeze.
  • Analysis of data regarding ICS efficacy in different preschool wheeze phenotypes.
  • Assessment of safety data, including systemic side effects on the hypothalamic-pituitary-adrenal axis, growth, and bone metabolism.

Main Results:

  • ICS are highly effective in persistent childhood asthma, improving lung function and reducing exacerbations.
  • ICS efficacy in preschool wheeze is more pronounced in the multiple-trigger wheeze phenotype compared to episodic viral wheeze.
  • Low to medium doses of ICS are safe in school-aged children with asthma, with reassuring safety data for preschoolers.

Conclusions:

  • ICS are a cornerstone treatment for persistent asthma in children.
  • Further research is needed to confirm the efficacy of small particle ICS in preschool children.
  • ICS demonstrate a favorable safety profile in pediatric populations when used appropriately.

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