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TUESDAY, Feb. 15 (HealthDay News) -- Inhaled corticosteroids as rescue medication with albuterol may be a useful step-down strategy for children with well-controlled, mild asthma as it is more effective at reducing exacerbations than is use of rescue albuterol alone in this population, according to a study published online Feb. 15 in The Lancet.
Fernando D. Martinez, M.D., from the University of Arizona in Tucson, and colleagues examined the effectiveness of beclomethasone dipropionate as a rescue treatment in a 44-week trial involving 288 children aged 5 to 18 with mild persistent asthma. Participants were randomly assigned to one of four groups: beclomethasone twice a day with beclomethasone plus albuterol as rescue (combined group), beclomethasone twice a day with placebo plus albuterol as rescue (daily beclomethasone), placebo twice a day with beclomethasone plus albuterol as rescue (rescue beclomethasone), and placebo twice a day with placebo plus albuterol as rescue (placebo). Time to first exacerbation requiring treatment with oral corticosteroids was the primary outcome.
The investigators identified a lower frequency of exacerbations in the daily (28 percent; P = 0.03), combined (31 percent; P = 0.07) and rescue (35 percent; P = 0.07) groups compared to placebo (49 percent). Treatment failure was significantly higher in the placebo group compared to the combined, daily, and rescue groups. Linear growth was 1.1 cm less in combined and daily groups, compared to placebo, but not in the rescue group.
"Our data suggest that inhaled corticosteroids used as rescue together with albuterol show benefits over rescue albuterol alone and avoid the growth effects associated with use of daily inhaled corticosteroid," the authors write.
Several authors disclosed financial relationships with a number of pharmaceutical companies, including GlaxoSmithKline.
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