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The use of inhaled corticosteroids in pediatric asthma: update
Elham Hossny1, Nelson Rosario2, Bee Wah Lee3
1Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, 11566 Egypt.
Insights
Improving childhood asthma control requires better adherence to inhaled corticosteroid (ICS) therapy. Education on inhaler technique and consistent daily use are crucial for effective asthma management in children.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Asthma Management
Background:
- Childhood asthma control remains suboptimal despite available inhaled corticosteroids (ICS) and guidelines.
- Poor adherence to daily ICS therapy is a significant barrier to effective asthma management.
- There is a need to improve asthma management plan uptake by families and healthcare providers.
Purpose of the Study:
- To review the mechanisms of action for inhaled corticosteroids (ICS).
- To provide recommendations on ICS dosage and therapeutic regimens.
- To discuss optimizing ICS effectiveness through improved inhaler technique and adherence, and to update knowledge on adverse events.
Main Methods:
- Literature review of inhaled corticosteroid (ICS) mechanisms.
- Analysis of current recommendations for ICS dosage and regimens.
- Evaluation of strategies to improve inhaler technique and adherence.
- Review of updated data on ICS adverse events.
Main Results:
- Inhaled corticosteroid (ICS) therapy is crucial for persistent childhood asthma, with a better safety profile than oral steroids.
- Optimizing ICS effectiveness depends on proper inhaler technique and consistent daily adherence.
- Adverse effects of ICS are generally less severe than those of oral glucocorticoids.
Conclusions:
- Effective childhood asthma management necessitates improved adherence to inhaled corticosteroid (ICS) therapy.
- Repetitive asthma education, including physical demonstration of inhaler use, is vital for adherence.
- Balancing the benefits of ICS against potential adverse effects is key, given their favorable safety profile compared to oral steroids.
Abstract:
Despite the availability of several formulations of inhaled corticosteroids (ICS) and delivery devices for treatment of childhood asthma and despite the development of evidence-based guidelines, childhood asthma control remains suboptimal. Improving uptake of asthma management plans, both by families and practitioners, is needed. Adherence to daily ICS therapy is a key determinant of asthma control and this mandates that asthma education follow a repetitive pattern and involve literal explanation and physical demonstration of the optimal use of inhaler devices. The potential adverse effects of ICS need to be weighed against the benefit of these drugs to control persistent asthma especially that its safety profile is markedly better than oral glucocorticoids. This article reviews the key mechanisms of inhaled corticosteroid action; recommendations on dosage and therapeutic regimens; potential optimization of effectiveness by addressing inhaler technique and adherence to therapy; and updated knowledge on the real magnitude of adverse events.
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