Fewer Inhaled Steroids OK for Asthmatic Kids?

Fewer Inhaled Steroids OK for Asthmatic Kids?

Study suggests some kids don't need daily dosing, but one expert worries the strategy might have risks

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

FRIDAY, May 27, 2016 (HealthDay News) -- Inhaled steroid therapy is commonly used to treat asthmatic children with persistent, daily wheezing episodes.

However, a new study suggests that the powerful medicines may not be needed on a daily basis for kids whose wheezing occurs sporadically, such as when they catch a cold.

"It makes sense that these children with frequent symptoms require daily treatment, whereas those who wheeze just during viral illnesses may only need treatment during illnesses," study lead author Dr. Sunitha Kaiser, of the University of California, San Francisco, said in a university news release.

Two experts who reviewed the study had different reactions to the findings, however.

"The less-frequent use of steroids is good news for children, since chronic steroid use can stunt growth," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.

Child asthma specialist Dr. Melodi Pirzada was more cautious.

"This article may put our preschooler asthmatics in dangerous territory," she said. "A child who is a known asthmatic without daily controller medications is at great risk to have a life-threatening asthma attack. In these cases, it is better to overdo treatment rather than come up short."

Pirzada is chief of pediatric pulmonary medicine at Winthrop-University Hospital in Mineola, N.Y.

In the new study, Kaiser's team analyzed 22 studies involving more than 4,500 children age 6 and younger. All suffered at least two episodes of asthma or wheezing in the previous year.

In 15 of the studies, kids with persistent asthma or wheezing had a 30 percent reduction in the risk of serious flare-ups if they used inhaled steroids on a daily basis.

Six other studies focused on more sporadic (not daily) use of the inhalers by kids whose wheezing was not persistent, and was typically only spurred by a cold. Those studies found a 35 percent reduction in flare-ups compared to a placebo, the researchers said.

Two more studies compared the effects of daily inhaled steroids and more sporadic inhaled steroid use in kids with wheezing induced by common colds. Those studies found no difference in the amount of severe flare-ups, Kaiser's group said.

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