Optimization of therapy in children with mild bronchial asthma to improve the disease control during seasonal acute respiratory infections

Abstract

Background. Children with mild bronchial asthma (BA) are prone to poor control of symptoms during seasonal acute respiratory infections (ARIs). Objective. To optimize therapy in children with mild BA to improve disease control during seasonal ARIs. Patients and methods. This single-blind placebo-controlled prospective single-center trial evaluating the efficacy of ammonium glycyrrhizinate (Reglisam, ‘VIFITECH,’ Russia) and lasting 4 months included 63 children with mild BA (21 in the placebo group) aged 5 to 10 years with a disease duration of at least 3 months. We assessed respiratory function, FeNO level, results of the asthma control test, characteristics of BA exacerbations, and the need for betamimetics and budesonide via a nebulizer. We used the Student's t-test and Wilcoxon test to evaluate the differences in mean and median values; the differences were considered significant at р < 0.05. Results. The frequency and mean duration of ARIs were lower in the group of active therapy (1.06 ± 0.35 episodes and 6.52 ± 2.19 days) than in the placebo group (1.77 ± 0.26 episodes and 10.83 ± 3.07 days). The differences were statistically significant (р = 0.036 and р = 0.019, respectively). Patients receiving placebo required longer budesonide administration per one BA exacerbation: 11.72 ± 1.98 days vs 8.65 ± 2.17 days in patients receiving active therapy (р = 0.026). Significant differences in the respiratory function and FeNO level were observed only in the subgroup of patients who had incomplete asthma control upon enrollment. We observed no new adverse events that had not been reported earlier. Conclusion. Our findings suggest high efficacy of ammonium glycyrrhizinate used to enhance basic therapy for mild BA in children, in whom respiratory infections are the most common triggers of BA exacerbations. Key words: ammonium glycyrrhizinate, basic therapy, children, mild bronchial asthma, acute respiratory infections (ARIs)