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Inhaled Corticosteroids Don't Prevent Asthma Development

Studies of high-risk toddlers and infants show failure to modify asthma progression

WEDNESDAY, May 10 (HealthDay News) -- In infants and young children at high risk for asthma, inhaled corticosteroid therapy does not modify the subsequent development of asthma, nor the progression from episodic to persistent wheezing, according to a pair of studies in the May 11 issue of the New England Journal of Medicine.

Theresa W. Guilbert, M.D., of the University of Arizona in Tucson, and colleagues -- several of whom have received compensation from drug companies -- assigned 285 children ages 2 to 3 years to receive either fluticasone propionate or placebo for two years, followed by a one-year period without study medication. During treatment, inhaled corticosteroid reduced symptoms and exacerbations, but also temporarily slowed growth. Treatment, however, did not change the development of asthma symptoms or lung function during the third, treatment-free year.

In a study supported by several drug companies, Hans Bisgaard, M.D., of Copenhagen University Hospital in Denmark, and colleagues assigned 411 one-month-old infants to two-week courses of inhaled budesonide or placebo after a three-day episode of wheezing, then studied them for three years. Intermittent inhaled corticosteroid therapy did not affect the progression of episodic to persistent wheezing and conveyed no short-term benefit during wheezing episodes.

"Given the potential risks of therapy in early life, prolonged treatment for toddlers under the age of 2 years should be highly selective," state the authors of an accompanying editorial.

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