Short-Term High-Dose Inhaled Steroids Do Not Prevent Asthma Flare-Ups in Children

Daniel Jackson, MD
Daniel Jackson, MD

Temporarily increasing the dosage of inhaled steroids when asthma symptoms start to worsen does not effectively prevent severe flare-ups, according to a new study led by Daniel Jackson, MD, an associate professor in the UW Department of Pediatrics and an expert on childhood asthma. And the common medical practice for children with mild to moderate asthma may be associated with slowing a child’s growth.

The study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, was published online March 3 in the New England Journal of Medicine (NEJM) to coincide with its presentation at a meeting of the 2018 Joint Congress of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the World Allergy Organization (WAO) in Orlando, Florida.

Asthma flare-ups in children are common and costly. To prevent them, many health professionals recommend increasing the doses of inhaled steroids from low to high at early signs of symptoms, such as coughing, wheezing, and shortness of breath. Until now, researchers had not rigorously tested the safety and efficacy of this strategy in children with mild to moderate asthma.

“These findings suggest that a short-term increase to high-dose inhaled steroids should not be routinely included in asthma treatment plans for children with mild to moderate asthma who are regularly using low-dose inhaled corticosteroids,” said Dr. Jackson. “Low-dose inhaled steroids remain the cornerstone of daily treatment in affected children.”

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