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Author Bisgaard, H. url  openurl
  Title Use of inhaled corticosteroids in pediatric asthma Type Journal Article
  Year (down) 1997 Publication Pediatric Pulmonology Abbreviated Journal Pediatr Pulmonol Suppl  
  Volume 15 Issue Pages 27-33  
  Keywords Administration, Inhalation; Adolescent; Adrenal Cortex Hormones/*administration & dosage/adverse effects; Adult; Airway Resistance/drug effects; Anti-Asthmatic Agents/*administration & dosage/adverse effects; Asthma/diagnosis/*drug therapy; Body Height/drug effects; Bronchial Hyperreactivity/diagnosis/drug therapy; Child; Child, Preschool; Humans; Infant; Lung Volume Measurements  
  Abstract Inhaled corticosteroids reduce asthma symptoms and exacerbations, improve lung function, and reduce airway inflammation and bronchial hyperreactivity more effectively than other treatments. However, inhaled corticosteroids may be unable to return lung function and bronchial hyperreactivity to normal when introduced for moderately severe asthma. This finding highlights the need to improve treatment strategy in pediatric asthma. The natural progression of persistent asthma may lead to loss of lung function and chronic bronchial hyperreactivity for children and adults. There is evidence to suggest that asthma acts via a chronic inflammatory process that causes remodeling of the airways with mucosal thickening and smooth muscle hypertrophy. An optimal treatment strategy would be one aimed at reducing the ongoing airway inflammation. Inhaled steroids ameliorate the inflammation, whereas this has not been documented for any other treatment. Delayed introduction of inhaled steroids appears to result in reduced improvement in lung function compared with the early use of inhaled steroids. This improved response from the earlier use of inhaled steroids appears to be valid at any stage of the disease. Therefore, a change in treatment strategy toward earlier introduction of corticosteroids may impede airway remodeling, bronchial hyperreactivity, and airway damage. No other treatment has been found to affect the course of the disease. Systemic side-effects, particularly inhibition of growth in asthmatic children using inhaled corticosteroids, do not seem to be cause for concern. Growth retardation has not been reported when inhaled corticosteroid doses of < or = 400 micrograms daily are individually tailored to each child's needs. The ongoing change in treatment strategy toward the earlier use of inhaled steroids in childhood asthma, as reflected in current revisions of various treatment strategies, therefore seems well founded.  
  Address Department of Pediatrics, National University Hospital, Copenhagen, Denmark  
  Corporate Author Thesis  
  Impact Factor 02,704 First Author Bisgaard, H. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Bisgaard, H.  
  ISSN 1054-187X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:9316099 Approved no  
  Call Number Serial 265  
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