NHLBI study says increase in steroids does not prevent asthma flare-ups

5th March 2018 (Last Updated March 5th, 2018 00:00)

A new study, funded by the US National Heart, Lung, and Blood Institute (NHLBI), has revealed that temporarily increasing the dosage of inhaled steroids when asthma symptoms begin to worsen does not effectively prevent severe flare-ups in children.

NHLBI study says increase in steroids does not prevent asthma flare-ups
The increase in doses of inhaled steroids from low to highcould slow a child’s growth. Credit: National Heart, Lung, and Blood Institute.

A new study, funded by the US National Heart, Lung, and Blood Institute (NHLBI), has revealed that temporarily increasing the dosage of inhaled steroids when asthma symptoms begin to worsen does not effectively prevent severe flare-ups in children.

Findings challenged the common medical practice of increasing dose levels at early signs of worsening symptoms, warning it could slow a child’s growth.

The study included 254 children between the age group of five and 11 years with mild-to-moderate asthma, and lasted for nearly a year. As part of the study, all the children were treated with low-dose inhaled corticosteroids, including two puffs from an inhaler twice daily.

At the earliest signs of asthma flare-up, which some children experienced a number of times across the study, the researchers continued giving low-dose inhaled steroids to half of them and increasing to high-dose inhaled steroids in the other half twice daily for seven days during each episode.

Researchers observed that though the children in the high-dose group had 14% more exposure to inhaled steroids than the low-dose group, they did not experience fewer severe flare-ups. The number of asthma symptoms, the length of time until the first severe flare-up, and the use of albuterol drug were reported to be similar between the two groups.

It was also found that the rate of growth of children in the short-term high-dose strategy group was about 0.23cm per year less than the rate of children in the low-dose strategy group.

“Low-dose inhaled steroids remain the cornerstone of daily treatment in affected children.”

Study leader Daniel Jackson said: "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-moderate asthma who are regularly using low-dose inhaled corticosteroids.

“Low-dose inhaled steroids remain the cornerstone of daily treatment in affected children.”

Asthma flare-ups in children are common and to prevent them, many health professionals currently recommend increasing the doses of inhaled steroids from low to high at early signs of symptoms, including coughing, wheezing, and shortness of breath.