Controlled trial of budesonide given by the nebuhaler in preschool children with asthma.

Gleeson, J. G. A.; Price, John

doi:10.1136/bmj.297.6642.163

Cited by 74 publications

(27 citation statements)

References 24 publications

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“…To allow for the modulating effect of treatment on symptom severity (attack severity, attack number, total severity score and interval score) the modelling was repeated after multiplying each severity score by 2 in those on inhaled steroids; this was performed with and without the three children on cromoglycate. A factor of 2 was chosen, as approximately a halving of symptoms following inhaled steroid therapy has been demonstrated in children of this age [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Multiplying the severity score by 2.0 in those receiving inhaled steroids, to allow for a possible beneficial effect, however, made no material difference to the results. Since, in carefully supervised placebo-controlled trials in this age group, the mean improvement in symptoms on inhaled steroids is approximately 30-60% [13,14], this adjustment is probably reasonable.…”

Section: Discussionmentioning

confidence: 99%

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Factors relating to the severity of symptoms at 5 yrs in children with severe wheeze in the first 2 yrs of life

Wilson

Doré²,

Silverman³

1997

Eur Respir J

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Factors relating to the severity of symptoms at 5 yrs in children with severe wheeze in the first 2 yrs of life. N.M. Wilson, C.J. Doré, M. Silverman. ERS Journals Ltd 1997. ABSTRACT: Wheezing in early childhood covers a wide spectrum of morbidity. Since little is known about the factors determining either the pattern or the severity of this range of symptoms, 51 children, admitted to hospital with acute wheeze in the first 2 yrs of life, were monitored prospectively between the ages of 4.5-5.5 yrs. Our hypothesis was that the predictors of severe episodes and of interval symptoms in 5 year olds would differ.Symptom diaries were kept, from which the symptom pattern and severity was assessed. The frequency and severity of acute episodes were analysed separately from day-to-day (interval) symptoms. A physiological assessment was made at 5 yrs.During the 12 month study period, 11 children were symptom-free, 15 were reported to wheeze only in response to viral infections, and 25 wheezed from multiple triggers. Bronchial responsiveness was significantly increased in those with a family history of asthma but was unrelated to any index of atopy. In a multiple logistic regression analysis, a family history of asthma and a personal history of allergy (but not results of skin-prick testing or serum immunoglobulin E (IgE)) significantly predicted both attack severity and interval symptoms. An additive effect of two factors (atopy plus a family history of asthma or bronchial responsiveness) on symptom severity was suggested, without any evidence of an interaction.It is concluded that in this population of 5 year olds, with an early history of severe wheezing, familial bronchial responsiveness and atopy of operated independently to determine both interval symptoms and attack severity. Eur Respir J 1997; 10: 346-353 This study was supported by a grant from the National Asthma Campaign.Several epidemiological studies have emphasized the high prevalence of wheeze in the first few years of life [1,2]. Overall prevalence statistics hide a wide spectrum of morbidity, ranging from a single mild episode to continuous disabling symptoms. Although the factors associated with the persistence of symptoms into early school years are becoming clearer [1], little is known of the factors that are associated with the severity of symptoms in the preschool age group. This is important, since the impact of wheezing disorders is clearly related to severity. There is an inherent problem of quantifying severity, since some children experience infrequent but severe attacks, whilst in others symptoms are milder but more frequent or persistent. It seems reasonable, therefore, to distinguish acute attacks, often related to viral infections [3], from other symptoms and to consider their frequency and severity separately. Since, in the population, episodic wheeze in the first few years is unrelated to atopy [4][5][6], in contrast to the situation in asthma in older children [7,8], it is likely that within the spectrum of early wheezing disorders that a...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors relating to the severity of symptoms at 5 yrs in children with severe wheeze in the first 2 yrs of life

Wilson

Doré²,

Silverman³

1997

Eur Respir J

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“…7, 20-22, 24-26, 28-32, 35-37 All were double-blind RCTs. Thirteen studies had a parallel design, and 2 had crossover designs: Gleeson and Price 28 and Webb et al 36 (3-week washout period and no washout, respectively). The studies used several different delivery systems and types of ICS, with most studies using medium daily doses (budesonide 0.4 mg/day, fluticasone 0.2 mg/day, beclomethasone 0.15 mg/day, ciclesonide 0.16 mg/day, flucinolide 40 μg/kg/day).…”

Section: Included Studiesmentioning

confidence: 99%

Preventing Exacerbations in Preschoolers With Recurrent Wheeze: A Meta-analysis

et al. 2016

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CONTEXT: Half of children experience wheezing by age 6 years, and optimal strategies for preventing severe exacerbations are not well defined.OBJECTIVE: Synthesize the evidence of the effects of daily inhaled corticosteroids (ICS), intermittent ICS, and montelukast in preventing severe exacerbations among preschool children with recurrent wheeze. LIMITATIONS: More studies are needed that directly compare these strategies. CONCLUSIONS:There is strong evidence to support daily ICS for preventing exacerbations in preschool children with recurrent wheeze, specifically in children with persistent asthma. For preschool children with intermittent asthma or viral-triggered wheezing, there is strong evidence to support intermittent ICS for preventing exacerbations.

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“…Two experienced exacerbations on placebo. Eleven of 18 parents whose children completed the maximum treatment preferred budesonide to placebo and one preferred placebo. Mean symptom scores on budesonide were better than on placebo for the 15 15 In this paper, we report the results of a double blind, crossover study investigating the effects of inhaled budesonide in wheezy infants who were less than 18 months of age.…”

Section: Introductionmentioning

confidence: 99%

Inhaled budesonide for chronic wheezing under 18 months of age.

Noble

Ruggins

Everard

et al. 1992

Archives of Disease in Childhood

101

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Controlled trial of budesonide given by the nebuhaler in preschool children with asthma.

Abstract: Objective-To determine whether the inhaled corticosteroid budesonide, given by a Nebuhaler spacing device, was effective in prophylaxis of asthma in preschool children.Design-Double blind, placebo controlled, random order crossover trial with two week practice run in period.Setting

Cited by 74 publications

References 24 publications

Factors relating to the severity of symptoms at 5 yrs in children with severe wheeze in the first 2 yrs of life

Factors relating to the severity of symptoms at 5 yrs in children with severe wheeze in the first 2 yrs of life

Preventing Exacerbations in Preschoolers With Recurrent Wheeze: A Meta-analysis

Inhaled budesonide for chronic wheezing under 18 months of age.

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