Steroids Do Not Slow Progression of Asthma Symptoms

Inhaled steroids control symptoms of asthma in toddlers but do not prevent progression of the disease, according to a study published Thursday in the New England Journal of Medicine, the Wall Street Journal reports.

Funded by NIH's National Heart, Lung and Blood Institute, researchers studied 285 children ages two or three with frequent wheezing and at least one major risk factor for asthma, including parental history or wheezing without colds. The children were treated with either a placebo or two daily puffs of Flovent -- a corticosteroid inhaler manufactured by GlaxoSmithKline -- for two years and then were followed for one year after (Levitz, Wall Street Journal, 5/11).

Researchers found that during the two-year treatment period, children receiving Flovent had significantly fewer and less severe asthma symptoms than those receiving the placebo. Children receiving the inhaled steroid had two days of symptoms per month compared to four days of symptoms per month in the placebo group.

In addition, those receiving the inhaled steroid had lower rates of severe episodes requiring further drug treatment. However, researchers found no significant differences between the participants in the two groups during the follow-up period after treatment ended (Scripps Howard/Arizona Daily Star, 5/11).

The study also finds temporary slowing of growth in children using the steroids, which has been previously documented (Wall Street Journal, 5/11). Children on the steroids were one centimeter behind in growth compared with those on the placebo, but the growth difference seemed to recede after medication was stopped (Auge, Denver Post, 5/11).

The study was conducted to determine if intensive treatments for inflammation could prevent the onset of asthma (Scripps Howard/Arizona Daily Star, 5/11). Inhaled steroids, which usually are the first line of defense prescribed to those with asthma, work by reducing inflammation and opening the airways to help patients breathe more easily (AP/Boston Globe, 5/11).

According to the Journal, the study "could change treatment standards" for asthma in children. An NIH advisory panel is meeting in Chicago this week to examine the findings and other recent research, with the possibility of revising federal guidelines (Wall Street Journal, 5/11).

The study is available online.