Children who suffer from asthma symptoms even while being treated with low-dose inhaled corticosteroids can benefit from either increasing the dose or from using one of two types of anti-asthma drugs, according to a study from Washington University in St. Louis.
The study by pediatric asthma specialists Robert C. Strunk, M.D., and Leonard B. Bacharier, M.D., aimed to see which of the three step-up theories recommended by the National Heart, Lung and Blood Institute was most effective for children whose asthma was not well-controlled. Those treatments are: double the dosage of the inhaled corticosteroid, add a long-acting beta antagonist (LABA), or add a leukotriene receptor antagonist (LTRA) to the inhaled corticosteroid treatment. Doctors find it difficult to predict which treatment will work best in a particular child, however, so the Washington University researchers used a triple-crossover, double blind approach to determine which treatments were most effective.
In the study, 168 children ages 6-18 were randomly given one of the step-up treatments for 16 weeks and their lung function, number of asthma attacks, and number of days their symptoms were under control were recorded at the end of the period. Then researchers would repeat the process with the next therapy.
Age, gender, or allergies played no role in which treatment worked best, but ethnicity did. African-American children did equally as well on the LABA treatment or the increased inhaled corticosteroid, while they did not respond as well to the LTRA. Caucasian children did best on the LABA.
Overall, 40 percent of patients showed the best response by adding the LABA, while nearly 30 percent of patients showed the best response by adding the LTRA and about 28 percent showed the best response by doubling the dose of inhaled corticosteroid. The LABA was more than 1.5 times as likely to produce the best response.
As a mom of a kid with asthma, I think even the relatively small study offers hope that those awful moments of watching our babies struggle to breathe could be lessened, if not ended entirely.