Treatment of asthma in young children: evidence-based recommendations

dc.contributor.authorCastro Rodríguez, José Antonio
dc.contributor.authorCustovic, Adnan
dc.contributor.authorDucharme, Francine M.
dc.date.accessioned2019-10-17T14:08:27Z
dc.date.available2019-10-17T14:08:27Z
dc.date.issued2016
dc.date.updated2019-10-14T19:14:14Z
dc.description.abstractAbstract In the present review, we focus on evidence-based data for the use of inhaled corticosteroids (ICS), leukotriene receptor antagonist (LTRA), long-acting beta2-agonits (LABA) and oral corticosteroids (OCS), with a special emphasis on well-performed randomized clinical trials (RCTs) and meta-analyses of such trials for the chronic management of asthma/wheeze in infants and preschoolers. Results: Seven meta-analyses and 14 RCTs were reviewed. Daily ICS should be the preferred drug for infants/preschoolers with recurrent wheezing, especially in asthmatics. For those with moderate or severe episodes of EVW, the use of high intermittent ICS doses significantly reduce the use of OCS. There is no evidence of effect of intermittent ICS at low-moderate dose in preschoolers with mild EVW episodes. In preschoolers with asthma, there were no significant differences between daily vs. intermittent ICS in terms of asthma exacerbations with insufficient power to conclude to equivalence; however, for other asthma control outcomes, daily ICS works significantly better than intermittent ICS for older children. Daily ICS is superior to daily or intermittent LRTA for reducing symptoms, preventing exacerbations, and improving lung function. No RCTs testing combination therapy with ICS and LABA (or LTRA) were published in infant/preschoolers. Parent-initiation of OCS at the first sign of symptoms is not effective in children with recurrent wheezing episode. In terms of ICS safety, growth suppression is dose and molecule-dependent but it’s effect is not cumulative beyond the first year of therapy and may be associated with some catch-up growth while on or off therapy. Linear growth must be monitored as individual susceptibility to ICS drugs may vary considerably.
dc.fuente.origenBiomed Central
dc.identifier.citationAsthma Research and Practice. 2016 Mar 02;2(1):5
dc.identifier.doi10.1186/s40733-016-0020-z
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26677
dc.identifier.urihttps://doi.org/10.1186/s40733-016-0020-z
dc.language.isoen
dc.nota.accesoContenido completo
dc.rightsacceso abierto
dc.rights.holderCastro-Rodriguez et al.
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.otherAsma en niñoses_ES
dc.subject.otherAsma infantiles_ES
dc.subject.otherCorticosteroides - Uso terapéuticoes_ES
dc.titleTreatment of asthma in young children: evidence-based recommendationses_ES
dc.typeartículo
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