New approaches to the treatment of childhood asthma

Current Opinion in Pediatrics

Volumn 10, Issue 3, 1998, Pages 243-249

  Rabinovitch, Nathan ^a   Gelfand, Erwin W ^a  

^a NATIONAL JEWISH MEDICAL AND RESEARCH CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BRONCHODILATING AGENT; CORTICOSTEROID; CYTOKINE; IMMUNOGLOBULIN E; INTERLEUKIN 4; INTERLEUKIN 5; LEUKOTRIENE RECEPTOR BLOCKING AGENT; MONOCLONAL ANTIBODY; SALMETEROL; THEOPHYLLINE;

ASTHMA; GROWTH RETARDATION; HUMAN; INHALATIONAL DRUG ADMINISTRATION; LUNG FUNCTION; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW; SIDE EFFECT; SYMPTOM;

ADMINISTRATION, INHALATION; ANTI-ASTHMATIC AGENTS; ANTI-INFLAMMATORY AGENTS; ANTIBODIES, ANTI-IDIOTYPIC; ANTIBODIES, MONOCLONAL; ASTHMA; CHILD; DRUG ADMINISTRATION SCHEDULE; DRUG THERAPY, COMBINATION; HUMANS; INTERLEUKINS; LEUKOTRIENE ANTAGONISTS; PRACTICE GUIDELINES; STEROIDS;

EID: 0031663194     PISSN: 10408703     EISSN: None     Source Type: Journal    
DOI: 10.1097/00008480-199806000-00004     Document Type: Review

References (38)

1. National Asthma Education Program, National Heart, Lung and Blood Institute: Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma. Bethesda, NIH. US Department of Health and Human Services, Pub. No. 91-3042, 1991.
2. National Asthma Education and Prevention Program, National Heart, Lung and Blood Institute: Expert Panel Report 2: Clinical Practice Guidelines for the Diagnosis and Management of Asthma. Bethesda, NIH Pub. No. 97-4051, April 1997.
3. Agertoft L, Pederson S: Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir Med 1994, 88:373-381.
4. Haahtela T, Jarvinen M, Kava T, et al.: Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. N Engl J Med 1994, 331:700-705.
5. Selroos O, Pietinalho A, Lofroos AB, Riska H: Effect of early vs. late intervention with inhaled corticosteroids in asthma. Chest 1995, 108:1228-1234.
6. Trigg CJ, Manolitsas ND, Wang J, et al.: Placebo-controlled immunopathologic study of four months of inhaled corticosteroids in asthma. Am J Respir Crit Care Med 1994, 150:17-22.
7. Olivieri D, Chetta A, Donno MD, Bertorelli G, Casalini A, Pesci A, Testi R, Foresi A: Effect of short-term treatment with low-dose inhaled fluticasone proprionate on airway inflammation and remodeling in mild asthma: A placebo-controlled study. Am J Respir Crit Care Med 1997, 155:1864-1871. The implication of this study is that there are early structural changes in the airways of mild asthmatic patients that are reversible with inhaled steroid treatment; how this occurs is unclear.
8. 2-agonist.
9. Simons FER and the Canadian Beclomethasone-Salmeterol Xinafoate Study Group: A comparison of beclomethasone, salmeterol, and placebo in children with asthma. N Engl J Med 1997, 337:1659-1665.
10. Verberne AA, Frost C, Roorda RJ, Laag H, Kerrebijn KF, and The Dutch Paediatric Asthma Study Group: One year treatment with salmeterol compared with beclomethasone in children with asthma. Am J Resp Crit Care Med 1997, 156:688-695. The fact that two large well done studies done by two separate groups had very similar outcomes in terms of efficacy as well as side effects of daily beclomethasone treatment makes the results even more compelling.
11. Meltzer EO, Orgel HA, Ellis EF, Eigen HN, Hemstreet MP: Long term comparison of three combinations of albuterol, theophylline and beclomethasone in children with chronic asthma. J Allergy Clin Immunol 1992, 90:2-11.
12. Price JF: Inhaled corticosteroids: Clinical relevance of safety measures. Pediatr Pulmonol Suppl 1997, 15:40-45. A concise, well-written review of the main safety-related issues associated with inhaled steroids.
13. Saha MT, Laippala P, Lenko HL: Growth of asthmatic children is slower during than before treatment with inhaled steroids. Acta Paediatr 1997, 86:138-42.
14. Price JF, Russel G, Hindmarsh PC, Weller P, Heaf DP, Williams J: Growth during one year of treatment with fluticasone proprionate or sodium cromoglycate in children with asthma. Pediatr Pulmonol 1997, 24:178-186. Although there were no statistically significant differences in height velocity between the fluticasone and sodium cromoglycate groups, there was a trend toward decreased height velocity (P = .08), with the mean difference approximately 0.5 cm over the 1-year period.
15. Agertoft L, Pederson S: Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir Med 1994, 88:373-381.
16. Silverstein MD, Yunginger JD, Reed CE, Petterson T, Zimmerman D, Li JTC, O'Fallon WM: Attained adult height after childhood asthma: Effect of glucocorticoid therapy. J Allergy Clin Immunol 1997, 99:466-474. Although these results were encouraging, the cumulative doses of inhaled steroids in these patients were low.
17. Wasserfallen JB, Baraniuk JN: Clinical use of inhaled corticosteroids in asthma. J Allergy Clin Immunol 1996, 97:177-182. A good review of the different inhaled steroids and relative potencies.
18. Leblanc P, Mink S, Keistinin Y, Saarlainen PA, Ringdal N, Payne SL: A comparison of fluticasone proprionate 200 mcg/day with beclomethasone diproprionate 400 mcg/day in adult asthma. Allergy 1994, 49:380-5.
19. Candemi JJ, Chervinski P, Goldstein MF, Ford LC, Berger WE, Ayars GH, Rogenes PR, Edwards L, Pepsin PJ: Fluticasone proprionate powder administered through Diskhaler versus triamcinolone acetonide aerosol administered through metered-dose inhaler in patients with persistent asthma. J Allergy Clin Immunol 1997, 100:467-474.
20. Wolthers OD, Hansen M, Juul A, Nielsen HK, Pederson S: Knemometry, urine cortisol excretion, and measures of the insulin-like growth factor axis and collagen turnover in children treated with inhaled glucocorticosterolds. Pediatr Res 1997, 41:44-50.
21. Wilson AM, Mcfarlane LC, Lipworth BJ: Dose response effect for adrenal suppression with repeated twice daily inhaled fluticasone propionate and triamcinolone acetonide in adult asthmatics. Am J Resp Crit Care Med 1997 156:1274-1277.
22. Boorsma M, Anderson N, Larsson P, Ullman A: Assesment of relative systemic potency of inhaled fluticasone and budesonide. Eur Respir J 1996, 9:1427-1432.
23. Clark DJ, Clark R, Lipworth BJ: Adrenal suppression with inhaled budesonide and fluticasone proprionate given by large volume spacer to asthmatic children. Thorax 1996, 51:941-943. In this investigator-blind crossover study, 10 children with stable asthma were randomized to receive either placebo or single doses of budesonide or fluticasone with a large volume spacer at doses of 400, 800, and 1250 μg. Overnight 12-hour urinary cortisol measurements showed significant suppression in urinary cortisol for all doses of fluticasone compared with placebo but not with any doses of budesonide.
24. Donnely R, Williams KM, Baker AB, Badcock C, Day RO, Seale JP: Effects of budesonide and fluticasone on 24 hour plasma cortisol: A dose-response study. Am J Respir Crit Care Med 1997, 156:1746-1751. Although fluticasone may have a high topical-to-systemic ratio in terms of drug bioavailability, it seems that it has such a high glucocorticoid receptor affinity that any systemic absorption will have significant systemic effects.
25. Evans DJ, Taylor DA, Zetterstrom O, Chung KF, O'Connor BJ, Barnes PJ: Low-dose budesonide and theophylline vs. high dose budesonide for moderate asthma. N Engl J Med 1997, 337:1412-1418.
26. Pauwels RA, LofDahl CJ, Postma DS, Tattersfeld AE, O'Bryne P, Barnes PJ, Ullman A: Effect of inhaled formoterol and budesonide on exacerbations of asthma. N Engl J Med 1997, 337:1405-1411.
27. Welch MJ, Levy S, Smith J, Feiss G, Farrar JR: Dose-ranging study of the clinical efficacy of twice-daily triamcinolone acetonide inhalation aerosol in moderately severe asthma. Chest 1997, 112:597-606. This article shows that most mild-to-moderate asthma can be controlled with low doses of low-potency inhaled steroids (200-800 μg/day). It also shows that there is little dose response the dose of triamcinolone is increased into the higher dose range. There is a nice discussion about the controversial question of whether there is a significant dose-response for any of the inhaled steroid preparations.
28. O'Byrne PM, Israel E, Drazen JF: Antileukotrienes in the treatment of asthma. Ann Intern Med 1997, 127:472-480. A very good review of the efficacy of anti-leukotriene treatment in asthma.
29. Adelroth E, Inman MD, Summers E, Pace D, Modi M, O'Byrne PM: Prolonged protection against exercise-induced bronchoconstriction by the leukotriene D4 receptor antagonist cinalukast. J Allergy Clin Immunol 1997, 99:210-215.
30. Dahlen B, Kumlin M, Margolskee DJ, Larseen C, Blomqvist H, Williams VC, Zetterstrom O, Dahlen SE: The leukotriene-receptor antagonist MK-0679 blocks airway obstruction induced by inhaled lysine-aspirin in aspirin-sensitive asthmatics. Eur Resp J 1993, 6:1018-1026.
31. 2-agonists, suggesting independent pathways of action.
32. Liu MC, Dube LM, Lancaster J, and the Zileuton Study Group: Acute and chronic effects of a 5-lipoxygenase inhibitor in asthma: A 6 month randomized multicenter trial. J Allergy Clin Immunol 1996, 98:859-871.
33. Suissa S, Dennis R, Ernst P, Sheehy O, Dauphinee S: Effectiveness of the leukotriene receptor antagonist zafirlukast for mild-moderate asthma: A randomized double-blind placebo-controlled study. Ann Intern Med 1997, 126:177-183. Patients on zafirlukast had significantly improved symptom scores and less need for rescue medications compared with those given placebo.
34. Fahy JV, Fleming HE, Wong HH, Liu JT, Su JQ, Reiman J, Fick RB, Boushey HA: The effect of an anti-IgE monoclonal antibody on the early and late-phase responses to allergen inhalation in asthmatic subjects. Am J Resp Crit Care Med 1997, 155:1828-1834.
35. Boulet LP, Chapman KR, Cote J, Kalra S, Bhagat R, Swystun VA, Laviolette M, Cleland LD, Deschenes F, Su JQ, Devault A, Fick RB, Cockcroft D: Inhibitory effects of an anti-IgE antibody E25 on allergen-induced early asthmatic responses. Am J Resp Crit Care Med 1997, 155:1835-1840.
36. Danzig M, Cuss F: Inhibition of lnterleukin-5 with a monoclonal antibody attenuates allergic inflammation. Allergy 1997, 52:787-794. Good review of some of the studies evaluating the role of II-5 in asthma and the effect of blocking II-5 in animal models.
37. Hogan SP, Koskinen A, Foster PS: Interleukin-5 and eoslnophils induce airway damage and bronchial hyperreactivity during allergic airway inflammation in BALB/c mice. Immunol Cell Biol 1997, 75:284-288.
38. Hammelman E, Oshiba A, Loader J, Larsen GL, Gleich GJ, Lee J, Gelfand EW: Anti-II-5 antibody prevents airway hyperresponsiveness in a murine model of airway sensitization. Am J Resp Crit Care Med 1997, 155:819-825.