Children on daily steroid treatments for asthma could begin to cut back on the therapy and its harmful side effects, according to a study conducted by National Jewish Health and other major health centers.
A study published today in the medical journal Lancet shows that mild asthma patients may be able to back off daily treatments and use steroids as a “rescue” or with less-frequent albuterol treatment.
Frequent, long-term steroid use can cause a minor stunting of growth and other side effects in children, said National Jewish researcher Dr. Stanley Szefler, who contributed to the study. Asthma specialists have been looking for safe ways to reduce that treatment.
Some families and doctors try abruptly stopping steroid treatment after symptoms have stabilized, but that strategy is not always effective, said Szefler, head of pediatric clinical pharmacology at National Jewish.
The 44-week, double-blind study of hundreds of children showed the best strategy for stable patients is reducing steroids from daily doses, but not stopping them altogether. The ideal “step down” approach would encourage patients to use inhaled steroids along with albuterol as a rescue when they feel asthma symptoms. Patients who need that treatment more than twice a week may need to return to daily steroids.
“This offers a good transition measure” to parents who want to cut back on drug treatments, Szefler said.
The study did not conclude whether “rescue” steroid use would also be a good “step up” recommendation for those children currently using just albuterol treatment, Szefler said. That will be a focus of future studies.
Asthma doctors are likely to review the Lancet results and consider alternatives for their stable patients. Parents who hear about the research should consult with their doctors about possible changes, Szefler said.
Michael Booth: 303-954-1686 or mbooth@denverpost.com
