Inhaled corticosteroids most effective for persistent asthma in children

While both inhaled corticosteroids (ICS) and leukotriene receptor antagonists (LTRA) have been proven to help control mild-to-moderate persistent asthma in school-age children, a new study shows ICS may be the more effective treatment.

Response Profiles to Fluticasone and Montelukast in Mild-to-Moderate Persistent Childhood Asthma is featured in the January 2006 issue of the Journal of Allergy & Clinical Immunology (JACI) and is currently available on the JACI's Web site. The JACI is the peer-reviewed, scientific journal of the American Academy of Allergy, Asthma and Immunology (AAAAI).

The 16-week study was conducted as a multi-center, double-masked, 2-sequence crossover trial by the National Heart, Lung and Blood Institute (NHLBI) Childhood Asthma Research and Education (CARE) Network. Researchers, led by Robert S. Zeiger, MD, PhD, from the University of California San Diego Department of Pediatrics, administered an ICS (fluticasone propionate) twice daily or an LTRA (montelukast) nightly to more than 100 children ages 6 to 17 who had mild-to-moderate persistent asthma.

Researchers found both fluticasone and montelukast led to significant improvements in many measures of asthma control. However, similar to earlier research, they found strong evidence of greater mean improvements after 8 weeks of therapy with an ICS compared with a LTRA across many other outcomes.

Patients taking ICS experienced more asthma control days (ACD) in which they had no daytime or night time asthma symptoms, along with better pulmonary responses and inflammatory biomarkers. As a comparison, 29.3 % of participants had at least one more ACD per week during treatment with fluticasone than during treatment with montelukast (12.2 %).