Children with mild persistent asthma showed varying responses to inhaled corticosteroids based upon factors such as age, gender and ethnicity, according to study results presented at the American Thoracic Society 2012 International Conference in San Francisco.
In stratified analyses of results previously published and funded by the National Heart, Lung, and Blood Institute (NHLBI), researchers reviewed a 44-week, double blind, placebo-controlled study of 288 children and adolescents aged 5 to 18 years treated with inhaled corticosteroids (ICS). The participants, enrolled in the NHLBI’s Treating Children to Prevent Exacerbations of Asthma (TREXA) study, were randomly assigned to four treatment strategies: daily ICS only (n=72), symptom-targeted rescue ICS (n=71), combined daily ICS plus symptom-targeted ICS (n=71), and placebo (n=74). The daily group received one 40 mcg ICS actuation twice daily, the rescue group was administered one 40 mcg ICS with each puff of albuterol, and the combined group used both treatments.
Researchers defined the primary outcome as the time to first exacerbation (TFE) when a participant experienced symptoms that necessitated an oral corticosteroid; secondary outcome was treatment failure (TF), defined as a participant experiencing two or more oral corticosteroid-requiring exacerbations.
All children with mild persistent asthma benefited from ICS treatment, researchers said, though some fared better. Younger children (aged 6 to 11 years vs. 12 to 17 years) in the daily and combined groups who were white, non-Hispanic, skin test positive, had IgE levels greater than 185K/uL, and had eczema responded better to ICS than the placebo group based upon TFE or TF. Those in the rescue group saw similar results when reaching TF.
“Some subgroups were more responsive to the ICS doses used, including children who were younger, male, white, non-Hispanic, and who had allergic asthma,” researchers concluded, adding that future studies were necessary for validation.
For more information: Gerald LB. Abstract #26378. Presented at: The American Thoracic Society, 2012 International Conference, May 18-23, San Francisco.