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Beclomethasone dipropionate aerosol for asthmatic children requiring maintenance oral steroid therapy
Insights
Inhaled beclomethasone dipropionate effectively manages asthma in children, offering an alternative to oral prednisolone. However, severe asthma exacerbations remain a risk, even with treatment.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pharmacology
Background:
- Severe chronic asthma in children often necessitates long-term oral corticosteroid therapy.
- Oral corticosteroids, while effective, carry risks of systemic side effects.
- Alternative inhaled therapies are sought to improve asthma management in pediatric populations.
Purpose of the Study:
- To compare the efficacy of inhaled beclomethasone dipropionate versus oral prednisolone in treating severe chronic asthma in children.
- To evaluate beclomethasone dipropionate as a potential alternative to oral steroids for asthma control.
Main Methods:
- A 10-month, single-blind crossover trial involving 14 children (aged 9-16 years) with severe chronic asthma.
- Participants required daily oral prednisolone (2-7.5 mg/day) for maintenance therapy.
- Comparison of symptom control between inhaled beclomethasone dipropionate (400 mcg/day) and oral prednisolone.
Main Results:
- Inhaled beclomethasone dipropionate (400 mcg/day) provided satisfactory asthma symptom control.
- The inhaled corticosteroid was found to be a viable alternative to oral prednisolone.
- Three children experienced sudden deaths during acute asthma exacerbations despite treatment.
Conclusions:
- Inhaled beclomethasone dipropionate is an effective alternative for managing severe chronic asthma in children, reducing the need for oral steroids.
- Severe asthma exacerbations and associated mortality remain significant concerns, even with inhaled corticosteroid therapy.
- Autopsy findings in deceased children revealed extensive tracheobronchial inflammation, highlighting the severity of their underlying condition.
Abstract:
A single-blind crossover trial comparing beclomethasone dipropionate by inhalation with prednisolone by mouth in the treatment of asthmatic children over a period of 10 months is reported. Fourteen children aged between nine and 16 years entered the trial. All had severe chronic asthma requiring maintenance oral prednisolone therapy in doses ranging from 2 to 7-5 mg/day. Beclomethasone dipropionate given by inhalation in a dose of 400 mug/day was found to be a satisfactory alternative to prednisolone by mouth for controlling the symptoms of asthma. During the course of this trial, three of the children died suddenly during acute exacerbations of asthma. All three had evidence of extensive inflammation of the tracheobronchial tree.