A comparison of inhaled fluticasone and oral prednisone for children with severe acute asthma
BACKGROUND: Inhaled corticosteroids are effective in the treatment of children with asthma. It is uncertain how inhaled corticosteroids compare with oral corticosteroids in the management of severe acute disease.
METHODS: We performed a double-blind, randomized trial involving 100 children five years of age or older who had severe acute asthma (indicated by a forced expiratory volume in one second [FEV1] that was less than 60 percent of the predicted value) and in whom the results could be evaluated. All were treated with an aggressive bronchodilator regimen and received one dose of either 2 mg of inhaled fluticasone through a metered-dose inhaler with a spacer or 2 mg of oral prednisone per kilogram of body weight. They were assessed hourly for up to four hours.
RESULTS: The mean (+/-SD) base-line FEV1 as a percentage of the predicted value was 46.3+/-12.5 in the fluticasone group (51 subjects) and 43.9+/-9.9 in the prednisone group (49 subjects). The FEV1 increased by a mean of 9.4+/-12.5 percentage points in the fluticasone group and by 18.9+/-9.8 percentage points in the prednisone group four hours after therapy (P< 0.001). None of the children in the prednisone group had a reduction in FEV1 as a percentage of the predicted value from base line to four hours, as compared with 25 percent of those in the fluticasone group (P<0.001). Sixteen (31 percent) of the children treated with fluticasone were hospitalized, as compared with five (10 percent) of those treated with prednisone (P=0.01).
CONCLUSIONS: Children with severe acute asthma should be treated with oral prednisone and not with inhaled fluticasone or a similar inhaled corticosteroid.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2000 |
|---|---|
| Erschienen: |
2000 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:343 |
|---|---|
| Enthalten in: |
The New England journal of medicine - 343(2000), 10 vom: 07. Sept., Seite 689-94 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Schuh, S [VerfasserIn] |
|---|
| Anmerkungen: |
Date Completed 07.09.2000 Date Revised 19.11.2015 published: Print Citation Status MEDLINE |
|---|
| Förderinstitution / Projekttitel: |
|
|---|
| PPN (Katalog-ID): |
NLM108953459 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM108953459 | ||
| 003 | DE-627 | ||
| 005 | 20231222150312.0 | ||
| 007 | tu | ||
| 008 | 231222s2000 xx ||||| 00| ||eng c | ||
| 028 | 5 | 2 | |a pubmed24n0364.xml |
| 035 | |a (DE-627)NLM108953459 | ||
| 035 | |a (NLM)10974132 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Schuh, S |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A comparison of inhaled fluticasone and oral prednisone for children with severe acute asthma |
| 264 | 1 | |c 2000 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 07.09.2000 | ||
| 500 | |a Date Revised 19.11.2015 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Inhaled corticosteroids are effective in the treatment of children with asthma. It is uncertain how inhaled corticosteroids compare with oral corticosteroids in the management of severe acute disease | ||
| 520 | |a METHODS: We performed a double-blind, randomized trial involving 100 children five years of age or older who had severe acute asthma (indicated by a forced expiratory volume in one second [FEV1] that was less than 60 percent of the predicted value) and in whom the results could be evaluated. All were treated with an aggressive bronchodilator regimen and received one dose of either 2 mg of inhaled fluticasone through a metered-dose inhaler with a spacer or 2 mg of oral prednisone per kilogram of body weight. They were assessed hourly for up to four hours | ||
| 520 | |a RESULTS: The mean (+/-SD) base-line FEV1 as a percentage of the predicted value was 46.3+/-12.5 in the fluticasone group (51 subjects) and 43.9+/-9.9 in the prednisone group (49 subjects). The FEV1 increased by a mean of 9.4+/-12.5 percentage points in the fluticasone group and by 18.9+/-9.8 percentage points in the prednisone group four hours after therapy (P< 0.001). None of the children in the prednisone group had a reduction in FEV1 as a percentage of the predicted value from base line to four hours, as compared with 25 percent of those in the fluticasone group (P<0.001). Sixteen (31 percent) of the children treated with fluticasone were hospitalized, as compared with five (10 percent) of those treated with prednisone (P=0.01) | ||
| 520 | |a CONCLUSIONS: Children with severe acute asthma should be treated with oral prednisone and not with inhaled fluticasone or a similar inhaled corticosteroid | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Androstadienes |2 NLM | |
| 650 | 7 | |a Anti-Asthmatic Agents |2 NLM | |
| 650 | 7 | |a Glucocorticoids |2 NLM | |
| 650 | 7 | |a Fluticasone |2 NLM | |
| 650 | 7 | |a CUT2W21N7U |2 NLM | |
| 650 | 7 | |a Prednisone |2 NLM | |
| 650 | 7 | |a VB0R961HZT |2 NLM | |
| 700 | 1 | |a Reisman, J |e verfasserin |4 aut | |
| 700 | 1 | |a Alshehri, M |e verfasserin |4 aut | |
| 700 | 1 | |a Dupuis, A |e verfasserin |4 aut | |
| 700 | 1 | |a Corey, M |e verfasserin |4 aut | |
| 700 | 1 | |a Arseneault, R |e verfasserin |4 aut | |
| 700 | 1 | |a Alothman, G |e verfasserin |4 aut | |
| 700 | 1 | |a Tennis, O |e verfasserin |4 aut | |
| 700 | 1 | |a Canny, G |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The New England journal of medicine |d 1945 |g 343(2000), 10 vom: 07. Sept., Seite 689-94 |w (DE-627)NLM000008184 |x 1533-4406 |7 nnns |
| 773 | 1 | 8 | |g volume:343 |g year:2000 |g number:10 |g day:07 |g month:09 |g pages:689-94 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 343 |j 2000 |e 10 |b 07 |c 09 |h 689-94 | ||