The Journal of allergy and clinical immunology · 2009
Patient characteristics associated with improved outcomes with use of an inhaled corticosteroid in preschool children at risk for asthma.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Bacharier Leonard B, Guilbert Theresa W, Zeiger Robert S, Strunk Robert C, Morgan Wayne J, Lemanske Robert F, Moss Mark, Szefler Stanley J, Krawiec Marzena, Boehmer Susan, Mauger David, Taussig Lynn M, Martinez Fernando D, Childhood Asthma Research and Education Network of the National Heart, Lung, and Blood Institute
Аннотация
BACKGROUND: Maintenance inhaled corticosteroid (ICS) therapy in preschool children with recurrent wheezing at high-risk for development of asthma produces multiple clinical benefits. However, determination of baseline features associated with ICS responsiveness may identify children most likely to benefit from ICS treatment.
OBJECTIVE: To determine if demographic and atopic features predict response to ICS in preschool children at high risk for asthma.
METHODS: Two years of treatment with an ICS, fluticasone propionate (88 microg twice daily), was compared with matching placebo in a double-masked, randomized, multicenter study of 285 children 2 and 3 years old at high risk for asthma development. Baseline demographic and atopic features were related to clinical outcomes in a post hoc subgroup analysis.
RESULTS: Multivariate analysis demonstrated significantly greater improvement with fluticasone than placebo in terms of episode-free days among boys, white subjects, participants with an emergency department (ED) visit or hospitalization within the past year, and those who experienced more symptomatic days at baseline. Children with aeroallergen sensitization experienced greater benefits in terms of oral corticosteroid use, urgent care and ED visits, and use of supplemental controller medications.
CONCLUSIONS: More favorable responses to ICS than placebo in high-risk preschool children over a 2-year period were more likely in those with a ED visit or hospitalization for asthma within the past year, children with aeroallergen sensitization, boys, and white subjects.
OBJECTIVE: To determine if demographic and atopic features predict response to ICS in preschool children at high risk for asthma.
METHODS: Two years of treatment with an ICS, fluticasone propionate (88 microg twice daily), was compared with matching placebo in a double-masked, randomized, multicenter study of 285 children 2 and 3 years old at high risk for asthma development. Baseline demographic and atopic features were related to clinical outcomes in a post hoc subgroup analysis.
RESULTS: Multivariate analysis demonstrated significantly greater improvement with fluticasone than placebo in terms of episode-free days among boys, white subjects, participants with an emergency department (ED) visit or hospitalization within the past year, and those who experienced more symptomatic days at baseline. Children with aeroallergen sensitization experienced greater benefits in terms of oral corticosteroid use, urgent care and ED visits, and use of supplemental controller medications.
CONCLUSIONS: More favorable responses to ICS than placebo in high-risk preschool children over a 2-year period were more likely in those with a ED visit or hospitalization for asthma within the past year, children with aeroallergen sensitization, boys, and white subjects.