CQ3　Is the intermittent inhaled corticosteroid therapy for persistent asthma in children effective?

Abstract

 Inhaled corticosteroids (ICS) are a cornerstone of treatment in long-term management of pediatric asthma in Japanese and worldwide asthma guidelines. Recent studies have suggested that intermittent use of ICS is effective in management of children with persistent asthma. We reviewed the evidence for the efficacy of intermittent ICS for persistent asthma in children in published randomized controlled trials.

 Five randomized controlled trials of intermittent ICS versus placebo for persistent asthma in 490 preschool and 145 school-aged children were analyzed. The results showed that use of intermittent ICS at onset of early symptoms reduced the likelihood of requiring rescue oral corticosteroids, compared to the placebo group. However, there were no significant differences in hospitalization rates, adverse events and quality of life between the two groups. More studies are needed to evaluate the best dose and regimen for ICS in this patient population.

 Results to date suggest that intermittent use of ICS should not be recommended as standard treatment for children with persistent asthma.