Although several medications are available to help children maintain asthma control, clinical trials directly comparing them have not been conducted. In fact, current recommendations in national and international asthma guidelines are based either on studies of single treatments compared to a placebo in children or on comparison studies in adults.
For the first time, researchers compared the effectiveness and safety of three different asthma medicines for initial daily therapy for school-aged children with mild to moderate persistent asthma: a low dose inhaled corticosteroid (200 mcg fluticasone a day); a combination of a lower dose inhaled corticosteroid and an inhaled long acting beta2 agonist (100 mcg fluticasone each morning plus 50mcg salmeterol twice daily), and a leukotriene receptor antagonist (montelukast). Studying 285 children ages 6 – 14 years, researchers in the Childhood Asthma Research and Education Network of the National Heart, Lung, and Blood Institute (NHLBI) found that after 48 weeks, inhaled corticosteroids are the most effective initial daily therapy for children with mild to moderate persistent asthma. They also found no significant adverse growth effects among any of the medicines studied.
"Long-term comparison of 3 controller regimens for mild-moderate persistent childhood asthma: The Pediatric Asthma Controller Trial," is published in this month's issue of the Journal of Allergy and Clinical Immunology (JACI). These results support the current asthma clinical guidelines, which recommend inhaled corticosteroids as the preferred initial therapy for children with mild to moderate asthma.
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