Rescue steroid strategy may benefit kids with asthma

CHILDREN with mild persistent asthma could be titrated down from daily inhaled corticosteroids (ICS) to a rescue-only combination of short-acting beta-agonist plus ICS, research suggests.

A multi-centre trial in 288 US children and teens with mild asthma confirmed daily ICS was the most effective in preventing exacerbations but the rescue strategy avoided growth impairment.

While daily beclomethasone halved the risk of first exacerbation, the rescue strategy reduced it by a third, the authors said.

The frequency of exacerbations was lowest at 28% in the group taking twice-daily beclomethasone plus salbutamol rescue, versus 31% in a group taking twice-daily ICS with beclomethasone plus salbutamol rescue, 35% in the rescue group (twice-daily placebo with beclomethasone and salbutamol rescue) and 49% in a placebo-only group.

Children taking daily ICS grew 1.1 cm less than children on placebo, but there was no significant effect on growth with