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Tailor Asthma Treatment for Kids

Study outlines how to tell which medicines to give which child

TUESDAY, Feb. 1, 2005 (HealthDayNews) -- Specific asthma characteristics in children may help doctors determine the most effective treatment for each child, according to researchers at the National Heart, Lung, and Blood Institute's (NHLBI) Childhood Asthma Research and Education Network.

"There is increasing evidence that children respond differently to the various treatment options for asthma," James Kiley, director of the NHLBI Division of Lung Diseases, said in a prepared statement.

For eight weeks, the researchers administered the inhaled corticosteroid drug fluticasone [Flonase] and another drug, the leukotriene receptor antagonist montelukast [Singulair], separately to 126 children with mild to moderate persistent asthma. They then evaluated each child's response to therapy, noting especially those cases where lung function improved by at least 7.5 percent.

According to the study, 17 percent of the children reached that goal when taking both medications; 23 percent reached the goal when taking only fluticasone; and 5 percent reached the goal when taking only montelukast.

Children who improved while on fluticasone had low pulmonary function and elevated markers of allergic inflammation at the beginning of the study, the researchers said. On the other hand, those children who improved while taking montelukast were younger and had a shorter duration of asthma symptoms.

Based on their findings, the researchers recommend daily treatment with inhaled corticosteroids for children with low lung function and/or elevated signs of allergic inflammation. In children who have no elevated signs of allergic inflammation, a therapeutic trial of either inhaled corticosteroids or leukotriene receptor antagonists like montelukast should be conducted, to determine which treatment is most effective.

The study appears in the February issue of the Journal of Allergy & Clinical Immunology.

"If we can pinpoint in advance which children will do better with a certain type of therapy, we can improve their lives more quickly and save them the risk of trying medications that are less effective for them. This study adds important information for identifying which children are more likely to respond well to inhaled corticosteroids," Kiley said.

More information

The American Lung Association has more about childhood asthma.

SOURCE: Journal of Allergy & Clinical Immunology, news release, Feb. 1, 2005
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