Asthma inhaler OK for kids, study finds

October 11, 2000
Web posted at: 5:09 p.m. EDT (2109 GMT)

From Elizabeth Cohen
CNN Medical Correspondent

ATLANTA, Georgia (CNN) -- A widely used inhaled-steroid treatment for children with asthma works well and has no long-term effects, according to the largest ever controlled study of treatments for childhood asthma.

"Although asthma experts around the world have recognized the effectiveness of inhaled corticosteroids in treating asthma, their long-term effects in children were not clear," said Dr. Claude Lenfant, director of the National Heart Lung and Blood Institute, the division of the National Institutes of Health that funded the study.

In particular, pediatricians have worried that inhaled corticosteroids might cause cataracts, growth retardation and changes in bone density, according to Dr. Stanley Szefler, lead author of the study and director of pediatric clinical pharmacology at the National Jewish Medical and Research Center in Denver.

The study, which is being published in this week's edition of the New England Journal of Medicine, found that steroids did not cause problems with bone density or cataracts. The medicine -- budesonide -- did cause a small but temporary reduction in the children's rate of growth.

Another study in the same journal found that children who received long-term treatment with budesonide attained normal adult height.

"We hope these results will convince more physicians and parents as well, that treating children with mild to moderate asthma with inhaled corticosteroids will result in better asthma control and improved quality of life," said Lenfant.

Szefler said he believes half of all children with mild to moderate asthma would benefit from inhaled steroids. He said currently about 25 to 30 percent of such children receive the drugs.

In the study, children taking budesonide had 45 percent fewer urgent care visits and 45 percent less use of oral steroids compared to children taking placebos. Oral steroids are used to treat severe asthma attacks.

A third group of children were given nedocromil, a non-steroid anti-inflammatory medication. Those taking nedocromil had 27 percent fewer urgent care visits and 16 percent less use of oral steroids compared to children taking placebos.

The five-year study, conducted at eight medical centers, included 1,041 children with asthma, ages 5 to 12.

In the United States, asthma affects close to 5 million children. Childhood asthma is a leading cause of school absences -- resulting in more than 11 million lost school days a year. It's estimated to cost the U.S. economy nearly $2 billion each year.

More drugs are being developed to treat asthma. One, called anti-IgE, is injected into the patient every other week and is thought to be more convenient than the steroids, which, in the study, were inhaled twice a day. Asthmatics produce too much IgE, or immunoglobin E, and the medicine contains an antibody to IgE made from human and mouse cells.

"Asthma is a high profile disease and there's lots of interest from pharmaceutical companies now that we understand more about the disease," said Szefler.

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American Lung Association -- Asthma
Breath of Life
JAMA -- Asthma Information Center
Allergy, Asthma & Immunology Online

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