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Inhaled steroids compared with disodium cromoglycate in preschool children with episodic viral wheeze
Author(s) -
De Baets F.,
Van Daele S.,
Franckx H.,
Vinaimont F.
Publication year - 1998
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/(sici)1099-0496(199806)25:6<361::aid-ppul1>3.0.co;2-k
Subject(s) - medicine , wheeze , disodium cromoglycate , inhaled corticosteroids , pediatrics , sodium cromoglycate , asthma , immunology
In school children with atopic asthma the beneficial effects of disodium cromoglycate (DSCG) and beclomethasone dipropionate (BDP) are well‐established. In preschool children, wheezing is quite common, and in the majority of cases the symptoms are episodic and reported to be associated with viral infections rather than atopy. We compared the efficacy of regular treatment with DSCG and BDP for prevention of wheezing in preschool children. We were interested to establish whether regular treatment with inhaled anti‐inflammatory drugs could lead to a decrease in bronchial responsiveness. In 15 patients (median age, 56 months; range, 43–66 months) bronchial responsiveness was assessed by measuring specific airway resistance (sR aw ) during a histamine provocation test. The concentration of histamine eliciting a 100% increase in sR aw (PC 100his ) was determined. In a double‐blind crossover study, patients inhaled either DSCG 10 mg three times a day or BDP 100 μg three times a day for 2 months. After a wash‐out period, treatment was changed to BDP or DSCG, respectively. Daily peak flow measurements were carried out, and exacerbations were noted. PC 100his was measured at the start and end of each treatment period. No significant decrease in bronchial responsiveness was seen (PC 100his DSCG: before 1.3, after 1.66 mg/ml, P value not significant; BDP: before 1.1 after 1.22 mg/ml, P value not significant). Significantly higher morning peak flows were observed on BDP therapy (160 on BDP vs. 150 L/min on DSCG, P < 0.03). BDP treatment resulted in significantly fewer wheezing exacerbations (7 vs. 16, P < 0.005) compared with DSCG therapy. We conclude that in preschool children with episodic virally induced wheezing, BDP therapy was superior to DSCG aerosol treatments for the prevention of exacerbations of wheezing, although no significant effect on bronchial responsiveness was noted during either treatment protocol. Pediatr Pulmonol. 1998; 25:361–366. © 1998 Wiley‐Liss, Inc.