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Protective effect of a low single dose inhaled steroid against exercise induced bronchoconstriction
R Visser1, M Wind2, B de Graaf1
1Department of Pediatrics, Medisch Spectrum Twente, KA Enschede, The Netherlands.
Insights
A low single dose of inhaled corticosteroids (ICS) significantly reduced exercise-induced bronchoconstriction (EIB) in most children with asthma. This finding suggests a potential acute treatment option for EIB in pediatric asthma patients.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Pharmacology
Background:
- Daily inhaled corticosteroids (ICS) are established for managing exercise-induced bronchoconstriction (EIB) in children with asthma.
- High single doses of ICS have demonstrated acute protective effects against EIB.
Purpose of the Study:
- To evaluate the efficacy of a low single dose of ICS in providing acute protection against EIB in pediatric asthma patients.
- To determine if a sub-therapeutic dose of ICS can mitigate EIB symptoms.
Main Methods:
- A prospective intervention study included 31 mild asthmatic children (5-16 years) with EIB, not on prior ICS treatment.
- Children underwent two exercise challenge tests (ECTs) within two weeks.
- Four hours before the second ECT, participants inhaled 200 μg of beclomethasone-dipropionate (BDP) via a breath-actuated inhaler (BAI).
Main Results:
- The median fall in FEV0.5/1 post-exercise was significantly reduced from 30.9% at baseline to 16.0% after BDP inhalation (P < 0.001).
- 64.5% of children (n=20) exhibited a good response (≥ 50% reduction in FEV0.5/1 fall).
- Moderate and no responses were observed in 8 (25-50%) and 3 (<25%) children, respectively.
Conclusions:
- A low single dose of ICS provides significant acute protection against EIB in the majority of children with asthma not on current ICS therapy.
- This suggests a potential role for single-dose ICS as an acute intervention for EIB in this population.
Objective:
Daily use of inhaled corticosteroids (ICS) reduces exercise induced bronchoconstriction (EIB) in asthmatic children. A high single dose of ICS also provided acute protection against EIB. Objective of this study is to investigate whether a low single dose of ICS offers protection against EIB in asthmatic children.
Methods:
31 Mild asthmatic children not currently treated with inhaled corticosteroids, 5-16 years, with EIB (fall in FEV0.5/1 ≥ 13%) were included in a prospective intervention study. They performed two ECT's within 2 weeks. Four hours before the second test children inhaled 200 μg beclomethasone-dipropionate (BDP) with a breath-actuated inhaler (BAI).
Results:
The median fall in FEV0.5/1 after 200 μg BDP was significantly reduced from 30.9% at baseline to 16.0% (P < 0.001). Twenty children (64.5%) showed a good response to 200 μg BDP (≥ 50% decrease in fall of FEV0.5/1), while 8 children showed a moderate response (25-50%), and three children showed no response at all (< 25%).
Conclusion:
A low single dose ICS offers acute protection against EIB in the majority of asthmatic children not currently treated with inhaled corticosteroids.
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