Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Clinical Pharmacology

Background:

• Childhood asthma management often involves inhaled corticosteroids.
• Long-term effects of inhaled budesonide on growth and pulmonary function require further investigation.
• Understanding optimal timing for inhaled corticosteroid initiation is crucial for pediatric asthma care.

Purpose of the Study:

• To evaluate the long-term effects of inhaled budesonide on growth and pulmonary function in children with asthma.
• To compare outcomes in children treated with inhaled budesonide versus those not receiving inhaled steroids.
• To assess the relationship between the timing of budesonide initiation and treatment efficacy.

Main Methods:

• Controlled prospective study involving 216 children with asthma.
• Follow-up at 6-month intervals for 1-2 years off budesonide, then 3-6 years on budesonide.
• Comparison with a control group of 62 children not treated with inhaled steroids.

Main Results:

• Budesonide treatment led to a significant reduction in annual hospital admissions for severe asthma.
• Forced expiratory volume in 1 second (FEV1) significantly improved over time with budesonide, unlike the control group.
• Initiating budesonide within two years of asthma onset resulted in significantly higher FEV1 compared to later initiation.

Conclusions:

• Long-term inhaled budesonide therapy is effective in improving pulmonary function and reducing asthma exacerbations in children.
• Early intervention with inhaled budesonide, particularly within the first two years of asthma onset, is associated with better long-term lung function.
• No tachyphylaxis was observed, and the mean daily dose of budesonide decreased over the treatment period.