Some children may not be able to keep their asthma under control even if they consistently report using inhaled corticosteroids, a mainstay of asthma treatment, suggests a new study presented at the American Thoracic Society 2007 International Conference, on Wednesday, May 23.
The study of 914 children with mild to moderate asthma found that over a one-year period, children who reported consistent inhaled steroid use were 20% less likely to report having well-controlled asthma compared with those not using any inhaled steroids. This finding held even when the severity of the children's asthma was taken into account.
“There may be several reasons for our findings; It is possible that some children are genetically less responsive to steroids,” says researcher Gregory Sawicki, M.D. of Children's Hospital in Boston. “In addition to issues of medication adherence and inability to completely control for differences in underlying asthma, severity can never be completely ruled out.”
Several studies of adults with asthma have suggested that even rigorous use of inhaled steroids doesn't lead to well controlled asthma in all adults, Dr. Sawicki noted. “But this issue hasn't been looked at closely in children,” he said. “Further studies are needed to see what is different about children who don't respond to steroids, to see if there is a way to predict whether a child will respond to inhaled steroids.”
Of the 914 children in the study, inhaled steroids were recommended for 435 who had persistent asthma, meaning they had symptoms on a regular basis. Among children who weren't recommended for inhaled steroid treatment, most reported well-controlled asthma. Among those recommended for inhaled steroid treatment, 44% reported consistently using the medicine; 35% said they intermittently used the medicine and 21% said they didn't use it at all.