CQ7 Are increased doses of inhaled corticosteroids useful for acute exacerbation of bronchial asthma in children?

Author(s):  
Norio Kawamoto ◽  
Mayu Shimizu ◽  
Kenichi Akashi ◽  
Hirokazu Arakawa
Author(s):  
Reashma Roshan ◽  
Mubashir H. Shah ◽  
Aejaz A. Bhat

Background: Recently published studies have suggested that inhaled corticosteroids may offer benefit over systemic steroids in bronchial asthma. This research was carried out to study the efficacy of inhaled budesonide and to compare the efficacy of inhaled budesonide with oral prednisolone in the treatment of acute moderate asthma in children.Methods: This was an open label randomized clinical trial. Children in the age group of 1-12 years with acute exacerbation of asthma presenting to pediatric emergency from November 1, 2015 to October 31, 2016 who fail to show prompt improvement after initial treatment with oxygenand three doses of inhaled salbutamol, were enrolled. Children in group B (n=35) and group P (n=35) received inhaled budesonide and oral prednisolone, respectively, in addition to oxygen inhalation and salbutamol as per the study protocol. Outcome was measured in terms of pulmonary score at the beginning, at 6 hours, and at 24 hours of starting the treatment. The analysis was undertaken according to intent to treat principle.Results: Baseline characteristics (sex, age, weight, height, body mass index) were comparable in the 2 groups. Mean heart rate, respiratory rate, pulmonary score at 6 and 24 hours, mean SpO2 at 24 hours were significantly showing normalizing trend (p<0.05) and mean hospital stay was significantly reduced [2.60 (±0.60) vs 3.11 (±0.80); p<0.05] in group B as compared to group P.Conclusions: Outcome measures of clinical improvement were better in inhaled budesonide group than oral prednisolone group in acute moderate exacerbation of bronchial asthma. 


2016 ◽  
Vol 1 (1) ◽  
pp. 63-67
Author(s):  
N. A. Geppe ◽  
N. G. Kolosova ◽  
S. I. Shatalina

Currently, the most effective drugs for the treatment and management of bronchial asthma (BA) are inhaled corticosteroids (ICS) which, according to global guidelines, are indicated as initial therapy for persistent asthma of any severity.


2018 ◽  
Vol 2018 (1) ◽  
pp. 26-32
Author(s):  
V. G. Chernusky ◽  
◽  
M. M. Popov ◽  
O. L. Govalenkova ◽  
G. V. Letyago ◽  
...  

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Olena Koloskova ◽  
Tetiana Bilous ◽  
Galyna Bilyk ◽  
Kristina Buryniuk-Glovyak ◽  
Olena Korotun ◽  
...  

The aim: To study the clinical and spirographic features persistence of the bronchial asthma in schoolchildren against the background of the alternative daily doses of inhaled corticosteroids to increase the effectiveness of anti-inflammatory therapy for this disease. Materials and methods: A complete comprehensive clinical-paraclinical examination of 65 schoolchildren with persistent asthma was conducted. According to the average daily dose of inhaled corticosteroids (ICS) the patients were divided into two clinical groups. The first (I) group consisted of 46 children who received ICS in the regimen of low-to-medium equipotent doses (253.95±9.98 μg per day), and the second (II) comparison group was formed of 19 patients who controlled the pBA using high doses of ICS (494.74±5.56 μg per day). Results: The patients of the І clinical group compared to patients of the ІІ group have a higher risk of the mild bronchial obstructive syndrome during asthma attacks. In assessing the level of control of persistent bronchial asthma using the CIA-scale, it was found that in II group cases of the controlled course of the disease were observed almost two times less than in children of the I group of comparison. In conducting spirography in children of comparison groups, it was shown that the ratio of indices of bronchospasm (FEV1/ FVC) was worse in patients receiving high doses of ICS. Conclusions: So, сharacteristic clinical feature of asthma controlled by high doses of ICS is more severe nature of bronchial obstructive syndrome during the period of exacerbation (OR=1.9-3.0). In the management of persistent bronchial asthma, the Gensler index which has high specificity (94.4%) and accuracy (92.2%) should be used for disease control verification.


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