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High-Dose Fluticasone Reduces Virus-Induced Wheezing in Young Children NEW YORK -- January 22, 2009 -- High doses of inhaled corticosteroids are effective in reducing the severity and duration of asthma attacks triggered by colds in young children, according to a study published in the January 22 issue of the New England Journal of Medicine. Basic asthma treatment -- administering weak doses of inhaled corticosteroids -- has not proven to be effective in children with viral-induced asthma. Therefore, Francine Ducharme, MD, Sainte-Justine Hospital Research Center and the Université de Montréal, Montreal, Quebec, and colleagues examined the efficacy and safety of pre-emptive treatment with high-dose fluticasone in reducing the severity of recurrent virus-induced wheezing in children. The study included 129 children, aged 1 to 6 years, who were randomly assigned to receive fluticasone propionate 750 mcg or a placebo twice daily, beginning at the onset of an upper respiratory tract infection and continuing for a maximum of 10 days, over a period of 6 to 12 months. The research team found that high doses of fluticasone, when inhaled at the onset of a cold and taken for up to 10 days, reduce the number of moderate or severe asthma attacks that require emergency oral steroids. A 20% reduction in the duration of the illness was also noted. The research team also noted that children who had received fluticasone had milder symptoms of shorter duration compared with the placebo group, thereby reducing the impact of the disease on the parents' quality of life. Over the 40-week monitoring period, researchers observed a slightly slower growth rate (4%) in children receiving fluticasone than in the placebo group. A slower average weight gain was noted in the children taking the placebo (approximately 2 kg) compared with the children treated with corticosteroids (1.5 kg). Since this type of asthma is temporary and usually disappears before the age of 6, the treatment probably has a transient effect on growth. For the research team, it remains to be confirmed whether the children will be able to make up for this slight growth retardation. SOURCE: University of Montreal E-mail this page to a friend or colleague! To print, use this version