2 year inhaled corticosteroid therapy did not prevent asthma in high risk preschool children after treatment was discontinued

doi:10.1136/ebm.11.6.174

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Evidence-Based Medicine 2006;11:174; doi:10.1136/ebm.11.6.174
Copyright © 2006 by the BMJ Publishing Group Ltd.

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Therapeutics

2 year inhaled corticosteroid therapy did not prevent asthma in high risk preschool children after treatment was discontinued

Guilbert TW, Morgan WJ, Zeiger RS, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med 2006;354:1985–97.[Abstract/Free Full Text]

Q In preschool children at high risk of asthma, does 2 year inhaled corticosteroid (IC) therapy prevent asthma after treatment is discontinued?

Clinical impact ratings GP/FP/Primary care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Allergy & immunology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Respirology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Paediatrics $*$ $*$ $*$ $*$ $*$ $*$ ${star}$

Key Words: androstadienes • asthma • bronchodilator agents • respiratory sounds

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial.

Allocation: {concealed^*}.

Blinding: blinded (patients, healthcare providers, {data collectors, andoutcome assessors}).^*

Follow up period: up to 3 years.

Setting: 5 clinical centres in the US.

Patients: 285 children 2–3 years of age (mean age 3 y, 62% boys)who had wheezing or allergy without other clinically significantmedical disorders, were at high risk of the persistence of asthma-likesymptoms during their school year, had received ICs for $<=$ 4 months,and did not require ICs during a run in month.

Intervention: an IC (fluticasone propionate, GlaxoSmithKline), 88 µgtwice daily (n = 143), or placebo (n = 142) for 2 years. Afterthat, all children were observed for 1 year.

Outcomes: proportion of episode free days during the observation year.Secondary outcomes included proportion of episode free daysduring the first 2 treatment years, exacerbations, supplementaryuse of fluticasone, unscheduled physician visits, hospital . . . [Full text of this article]

Bruce Mazer, MD

McGill University Health Centre-Montreal Children’s Hospital,
Montreal, Quebec, Canada

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Glossary
Evid. Based Med. 2006 11: 191. (in Glossary) [Extract] [Full Text] [PDF]