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Short-term efficacy and side effects of cloprednol in children with asthma
Insights
Single daily cloprednol proved more effective than alternate-day prednisolone for treating severe childhood asthma over six weeks. Cloprednol improved lung function and reduced asthma symptoms with comparable adrenal suppression.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
Background:
- Severe asthma in children necessitates long-term corticosteroid therapy.
- Alternate-day prednisolone is a common treatment, but its efficacy and safety profile require ongoing evaluation.
Purpose of the Study:
- To compare the efficacy and safety of single daily cloprednol versus alternate-day prednisolone in children with severe asthma.
- To assess the impact on clinical asthma indices and pulmonary function.
Main Methods:
- A six-week clinical trial involving 11 children with severe asthma requiring intensive medical supervision.
- Evaluation of clinical efficacy using symptom scores, asthma attacks, severity scores, and bronchodilator use.
- Assessment of pulmonary function tests (FEV1, FVC, PEFR) and plasma cortisol levels.
Main Results:
- Single daily cloprednol demonstrated superior efficacy compared to alternate-day prednisolone across all clinical indices.
- Significant improvements in FEV1, FVC, and PEFR were observed during the cloprednol treatment period.
- Plasma cortisol levels indicated partial pituitary-adrenal suppression with cloprednol, comparable to alternate-day prednisolone.
Conclusions:
- Single daily dosing of cloprednol is more effective than alternate-day prednisolone for severe pediatric asthma.
- Cloprednol offers a potentially improved therapeutic option for managing severe asthma in children.
- Further research may explore long-term outcomes and optimal dosing strategies for cloprednol.
Abstract:
Efficacy and safety of alternate-day prednisolone compared to single daily cloprednol were evaluated over a six-week period in 11 children with severe asthma requiring in-residence medical supervision and long-term corticosteroid therapy. Clinical indices of efficacy, including daily pulmonary symptom scores, number of asthma attacks, asthma severity scores, and bronchodilator usage, all favored cloprednol. Afternoon pulmonary function tests (FEV1, FVC, and PEFR) were all significantly improved during the cloprednol period. Although plasma cortisol values remained within the broad range of normal during the cloprednol period, mean values were consistent with partial pituitary-adrenal suppression similar in degree to that observed 24 hours after administration of an alternate-day program of prednisolone therapy. The results of this trial showed cloprednol in single daily doses to be more effective than prednisolone in alternate doses for the treatment of children with severe asthma.