May 12, 2006 -- In Preschoolers, Inhaled Medication Does Not Prevent Later Asthma

Treatment with inhaled corticosteroids “is associated with significant improvement in various measures of asthma control” in school-age children, and researchers wondered if receiving an inhaled corticosteroid would also reduce the likelihood of asthma in preschoolers who have frequent wheezing or other risk factors for asthma. But a multicenter, double-blind, placebo-controlled, parallel-group trial of inhaled fluticasone in children two to three years old found that, while the children had more episode-free days during treatment, when the treatment was stopped after two years there was no significant difference in the later development of asthma symptoms. “These findings do not provide support for a subsequent disease-modifying effect of inhaled corticosteroids after the treatment is discontinued,” researchers said. They noted that studies of the natural history of asthma show that initial symptoms commonly occur during the first year of life, and children who have frequent wheezing without colds or who have personal or family histories of asthma or atopic dermatitis are believed to be at special risk of developing asthma. The research report, “Long-Term Inhaled Corticosteroids in Preschool Children at High Risk for Asthma,” is published in the May 11, 2006, issue of the New England Journal of Medicine.