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Allergy and Airway |

Safety and Efficacy of Oral Versus Inhaled Corticosteroids in Moderate Persistent Asthma in Children 6 to 15 Years Old: A Randomized Controlled Trial FREE TO VIEW

Yadnee Estrera, MD; Arnel Gerald Jiao, MD; Jemaila Valles, MD; Josy Naty Venturina, MD
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Philippine Children's Medical Center, Quezon City, Philippines


Chest. 2014;145(3_MeetingAbstracts):8A. doi:10.1378/chest.1748893
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Abstract

SESSION TITLE: Asthma Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: This study aimed to determine if the use of low dose oral corticosteroid is a safe and effective alternative treatment for children with moderate persistent asthma.

METHODS: Forty patients, 6 to 15 years old, with newly diagnosed moderate persistent asthma were randomized into two groups. For 3 months, the control group received inhaled corticosteroid (budesonide) at 200mcg twice daily while treatment group received a single morning dose of oral corticosteroid (prednisone) at 0.5mg/kg (maximum dose:10mg/day). Efficacy was assessed based on daytime and nighttime coughing, limitation of activity, use of bronchodilators, FEV1, PEFR and level of asthma control. Safety parameters evaluated were blood pressure, pre and posttreatment determination of serum cortisol and fasting blood sugar levels.

RESULTS: Study participants from both groups showed comparable improvement in daytime and nighttime cough, need for bronchodilators and limitation of activity. PEFR is the only parameter that showed a significant difference, participants under the inhaled corticosteroid group showed lower PEFR values than the oral corticosteroid group throughout the entire study period. There was no significant difference in their FEV1 but basically had the same trend as that of the PEFR. There was no significant difference in the safety parameters evaluated. Study participants from both groups showed a decrease in cortisol levels after 3 months of treatment but none had signs and symptoms of adrenal insufficiency.

CONCLUSIONS: There was no significant difference in the safety and efficacy of oral versus inhaled corticosteroid in the treatment of children with moderate persistent asthma after 3 months of treatment.

CLINICAL IMPLICATIONS: These findings do not aim to replace inhaled corticosteroid as the mainstay of treatment for persistent asthma but to find a suitable, effective and more importantly, a safe alternative treatment for patients with uncontrolled asthma in third world countries.

DISCLOSURE: The following authors have nothing to disclose: Yadnee Estrera, Arnel Gerald Jiao, Jemaila Valles, Josy Naty Venturina

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