Efficacy and safety of ciclesonide once daily and fluticasone propionate twice daily in children with asthma

Abstract

, et al.. Efficacy and safety of ciclesonide once daily and fluticasone propionate twice daily in children with asthma.

Assessment of Controversial Pediatric Asthma Management Options Using GRADE

“…13,14,17,18 There were no significant differences between ciclesonide and other ICS (budesonide or fluticasone) in asthma symptom score and exacerbations, except for 1 study showing significantly more exacerbations in the CIC group (Table 4). Side effects (such as oropharyngeal candidiasis and hoarseness) occurred with similar frequency in both groups.…”

“…However, 7 RCTs were found: 2 using extra-fine HFA beclomethasone and 4 CIC. [13][14][15][16][17][18] Because these agents have different pharmacokinetic and pharmacodynamic properties, they are discussed separately.…”

Special considerations—asthma in children

“…For example, inhaled ciclesonide and mometasone are approved for once-daily administrations in select geographic regions. 76,77 Though noted to result in improvement in lung function in adult-based studies, a systematic review of studies children aged 4 to 17 years of age could not demonstrate a significant improvement in asthma symptoms using oncedaily ciclesonide compared to twice-daily budesonide administration (risk ratio [RR] 2.20; 95% confidence interval [CI], 0.75 to 6.43). 78 Moreover, concerns have arisen for dose-and duration-dependent adverse effects of daily ICS therapies on linear growth and bone mineral density.…”

The Role of Small Airways in Childhood Asthma

“…After switching to BDP-HFA, FEF 25%-75% improved from 50.75% to 68.85% predicted (P < 0.001), and FEV 1 improved from 84.6% to 93.8% predicted (P = 0.001). 71 Several studies 13,73,[84][85][86][87][88][89] have assessed the effects of ciclesonide, another approved aerosol solution with a small particle size. Hoshino compared ciclesonide (200 mg once daily) and fluticasone (100 mg twice daily) for 5 weeks in thirty mild adult asthmatics using IOS and induced sputum eosinophils.…”