TY - JOUR
T1 - Addition of salmeterol versus doubling the dose of beclomethasone in children with asthma
AU - Verberne, AAPH
AU - Frost, C
AU - Duiverman, EJ
AU - Grol, MH
AU - Kerrebijn, KF
AU - Raaymakers, JAM
AU - Pocock, SJ
AU - Bogaard, JM
AU - van Nierop, Jacobus
AU - Nagelkerke, AF
AU - Thio, B
AU - van Essen-Zandvliet, EEM
AU - Denteneer, A
AU - Gerritsen, J
AU - Grol, MJ
AU - Hendriks, JJE
AU - Kouwenberg, JM
AU - van der Laag, J
AU - Brackel, HJL
AU - Dutch Paediat Asthma Study Grp
PY - 1998/7
Y1 - 1998/7
N2 - Studies in adults revealed that addition of salmeterol to a moderate dose of inhaled corticosteroid resulted in better symptom control and higher PEF compared with doubling the dose of inhaled corticosteroid. The aim of this three group study was to compare the effects of a moderate dose of beclomethasone, the same dose of beclomethasone with salmeterol, and a doubling dose of beclomethasone on lung function and symptoms in children with moderate asthma. A total of 177 children already treated with inhaled corticosteroids, were randomized in a double-blind parallel study either to salmeterol 50 mu g twice daily (BDP400+salm), beclomethasone 200 mu g twice daily (BDP800), or placebo (BDP400) in addition to beclomethasone 200 mu g twice daily. No significant differences between groups were found in FEV1, PD20 methacholine, symptom scores, and exacerbation rates after 1 yr. Salmeterol resulted in slightly better PEF in the first months of treatment. FEV1, and PD,, methacholine significantly improved in all groups. After 1 yr mean changes in FEV,, percent predicted were 4.3% (95% CI 1.3; 7.2), 5.8% (95% CI 2.9; 8.7), and 4.3% (95% CI 2.1; 6.5) for BDP400+salm, BDP800, and BDP400, respectively. Changes in airway responsiveness were 0.60 (95% CI 0.05; 1.14), 1.30 (95% CI 0.73; 1.87), and 0.80 (95% CI 0.33; 1.27) doubling doses. Growth was significantly slower in the BDP800 group. We conclude that no additional benefit was found of adding either salmeterol or more beclomethasone to a daily dose of 400 mu g beclomethasone in this group of children with excellent compliance of medication.
AB - Studies in adults revealed that addition of salmeterol to a moderate dose of inhaled corticosteroid resulted in better symptom control and higher PEF compared with doubling the dose of inhaled corticosteroid. The aim of this three group study was to compare the effects of a moderate dose of beclomethasone, the same dose of beclomethasone with salmeterol, and a doubling dose of beclomethasone on lung function and symptoms in children with moderate asthma. A total of 177 children already treated with inhaled corticosteroids, were randomized in a double-blind parallel study either to salmeterol 50 mu g twice daily (BDP400+salm), beclomethasone 200 mu g twice daily (BDP800), or placebo (BDP400) in addition to beclomethasone 200 mu g twice daily. No significant differences between groups were found in FEV1, PD20 methacholine, symptom scores, and exacerbation rates after 1 yr. Salmeterol resulted in slightly better PEF in the first months of treatment. FEV1, and PD,, methacholine significantly improved in all groups. After 1 yr mean changes in FEV,, percent predicted were 4.3% (95% CI 1.3; 7.2), 5.8% (95% CI 2.9; 8.7), and 4.3% (95% CI 2.1; 6.5) for BDP400+salm, BDP800, and BDP400, respectively. Changes in airway responsiveness were 0.60 (95% CI 0.05; 1.14), 1.30 (95% CI 0.73; 1.87), and 0.80 (95% CI 0.33; 1.27) doubling doses. Growth was significantly slower in the BDP800 group. We conclude that no additional benefit was found of adding either salmeterol or more beclomethasone to a daily dose of 400 mu g beclomethasone in this group of children with excellent compliance of medication.
KW - LONG-TERM TREATMENT
KW - INHALED CORTICOSTEROIDS
KW - LUNG-FUNCTION
KW - BRONCHIAL RESPONSIVENESS
KW - CHILDHOOD ASTHMA
KW - AIRWAY
KW - SALBUTAMOL
KW - STATEMENT
KW - SYMPTOMS
KW - GROWTH
U2 - 10.1164/ajrccm.158.1.9706048
DO - 10.1164/ajrccm.158.1.9706048
M3 - Article
C2 - 9655732
SN - 1073-449X
VL - 158
SP - 213
EP - 219
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 1
ER -