Abstract
Uncontrolled asthma in children can result in significant morbidity, activity limitations, and financial burden. Current National Asthma Education and Prevention Program asthma management guidelines recommend that all children with persistent asthma receive longterm inhaled corticosteroids (ICSs) controller therapy. Other controller medications, such as cromolyn and nedocromil, are less effective alternatives to ICSs in children with persistent asthma. Although comparative studies need to be conducted in children, the results of several adult studies suggest that ICSs are more effective than leukotriene modifiers as longterm controller monotherapy in patients with moderate to severe persistent asthma. Early ICS intervention is important in children with persistent asthma, as the greatest losses in lung function typically occur in the early stage of disease. Once initiated, ICS therapy should be administered on a regular basis, because discontinuing ICS use may result in increased asthma symptoms, asthma exacerbations, and rescue medication use. Importantly, numerous studies have demonstrated that, when used at recommended doses, ICSs are safe for long-term use in children with asthma, with no clinically significant effects on growth, bone mineral density, vision, or adrenal function. Physicians should choose the most appropriate device for ICS delivery based on the patient's individual needs. (Pediatr Asthma Allergy Immunol 2005; 18[4]:247–258.)
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