Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Corticosteriods Are Safe in Asthma

Category: Asthma and Allergy


In the December 1992 Annals of Allergy, an important study was summarized by Dr. Katsunuma on the safety of using inhaled beclomethisone. Beclomethisone is the active ingredient in two inhaled corticosteroids used to control asthma in both children and adults. The brand names are Vanceril and Beclovent. The use of this inhaled corticosteroid and two other brands produced by other companies has been the main stay of treatment recommended by the National Institute of Health and used by most pediatricians, allergists and pulmonologists. The concern we all have, however, is just how much inhaled corticosteroids and for how long is it safe to use with children? Most studies have shown a high limit of safety potential in both children and adults. This study confirms all the previous studies and clarifies some of the conflicting results in a few recent studies which have concerned us about possible suppression of adrenal function when using this treatment method. 300 micrograms per day is equivalent to 6 puffs per day and is a relatively conservative dose for middle size children such as age 8 to 15. In this particular study, 10 boys and 2 girls were studied. Nine children completed the study and in all nine there was no change in adrenal function measured several different ways both before and after the use of the beclomethisone.

This study is one more study reassuring us about the safe use of inhaled corticosteroids in children. The bottom line in treating asthma is the importance of controlling inflammation. Inhaled corticosteroids as well as inhaled cromalin sodium (Intal) are effective ways of doing this. The inhaled corticosteroids are usually much more effective for moderate to severe asthma and the inhaled Intal is just as good in mild asthma patients. The wise use of inhaled corticosteroids is to use the necessary dose including doses even higher than those used in this study for a short time such as 2 to 4 weeks, to maintain very good asthma control. Then dose down to a nice, safe conservative level such as in this study. Having done this for over 10 years and reviewing numerous studies from around the world, I feel that it is the wisest way of controlling asthma. Poorly controlled, asthma is a frustrating disease causing lots of suffering, loss of school, decrease in desired activities (such as sports), and even loss of sleep due to night time coughing. If you are having any difficulty in controlling your child's asthma, consider the findings of this study and discuss them with your physician.