Steroids in Kids With Wheezing Ineffective
Steroids in Kids With Wheezing Ineffective
Treatment May Be Ineffective in Young Children
Oct. 30, 2003 -- Preschoolers who wheeze because of a viral cold are commonly treated with oral steroids, but a new study from the U.K. finds that the therapy is ineffective. The research could have major implications for the management of young children with wheezing symptoms.
Episodic attacks of wheezing triggered by colds are common in preschool children, are usually transient and often diagnosed and treated as asthma. Oral steroids have been shown to be a highly effective asthma treatment in adults and children over the age of 6, but the data on their usefulness in young children with wheezing are conflicting. The goal of this treatment is to reduce inflammation within the lungs and prevent further wheezing and respiratory symptoms.
"Most children who wheeze are asymptotic by age 6," pediatric pulmonologist Jonathan Grigg, MD, tells WebMD. "The vast majority of wheezy children don't have (persistent) allergic asthma. But we can't easily tell who does and who does not."
Grigg and colleagues from the University of Leicester followed a group of children with a history of wheezing to see if active steroid treatment was more effective than no treatment at all. At the start of a wheezing attack, 51 children were given a five-day course of the oral steroid prednisolone and 69 were given placebo treatments.
No difference was seen in the two groups with regard to daytime or nighttime respiratory symptoms, and there was no difference in hospitalizations rates for those treated with steroids and those treated with placebo. The findings are published in the Nov. 1 issue of The Lancet.
The researchers also measured eosinophil levels -- blood cells that are key indicators of asthma and allergic reactions. They found no treatment-related differences in symptoms or hospital admissions between children with high and low levels of the allergy and asthma marker. Previous studies have shown that children with higher levels of blood eosinophils are more likely to subsequently develop asthma at follow-up.
"This treatment appeared to be no more effective in the children with the most allergic features," Grigg says. "The conclusion from our study is that steroids are much less effective for treating young children with classic asthma than they are in adults and adolescents."
They write that in children with viral wheezing oral steroid did not appear to be effective treatment to reduce symptoms or hospitalizations. The researchers also show in the study that there was no evidence of a benefit in children with classic asthma or increased eosinophils.
Steroids in Kids With Wheezing Ineffective
Treatment May Be Ineffective in Young Children
Oct. 30, 2003 -- Preschoolers who wheeze because of a viral cold are commonly treated with oral steroids, but a new study from the U.K. finds that the therapy is ineffective. The research could have major implications for the management of young children with wheezing symptoms.
Episodic attacks of wheezing triggered by colds are common in preschool children, are usually transient and often diagnosed and treated as asthma. Oral steroids have been shown to be a highly effective asthma treatment in adults and children over the age of 6, but the data on their usefulness in young children with wheezing are conflicting. The goal of this treatment is to reduce inflammation within the lungs and prevent further wheezing and respiratory symptoms.
"Most children who wheeze are asymptotic by age 6," pediatric pulmonologist Jonathan Grigg, MD, tells WebMD. "The vast majority of wheezy children don't have (persistent) allergic asthma. But we can't easily tell who does and who does not."
No Impact on Symptoms
Grigg and colleagues from the University of Leicester followed a group of children with a history of wheezing to see if active steroid treatment was more effective than no treatment at all. At the start of a wheezing attack, 51 children were given a five-day course of the oral steroid prednisolone and 69 were given placebo treatments.
No difference was seen in the two groups with regard to daytime or nighttime respiratory symptoms, and there was no difference in hospitalizations rates for those treated with steroids and those treated with placebo. The findings are published in the Nov. 1 issue of The Lancet.
The researchers also measured eosinophil levels -- blood cells that are key indicators of asthma and allergic reactions. They found no treatment-related differences in symptoms or hospital admissions between children with high and low levels of the allergy and asthma marker. Previous studies have shown that children with higher levels of blood eosinophils are more likely to subsequently develop asthma at follow-up.
"This treatment appeared to be no more effective in the children with the most allergic features," Grigg says. "The conclusion from our study is that steroids are much less effective for treating young children with classic asthma than they are in adults and adolescents."
They write that in children with viral wheezing oral steroid did not appear to be effective treatment to reduce symptoms or hospitalizations. The researchers also show in the study that there was no evidence of a benefit in children with classic asthma or increased eosinophils.
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