Evaluation of a clinical algorithm involving serum eosinophil cationic protein for guiding the anti-inflammatory treatment of bronchial asthma in childhood

A pilot study was performed to investigate a clinical algorithm using serum‐eosinophil cationic protein level (S‐ECP) as an objective parameter for tapering the anti‐inflammatory treatment in chronic childhood asthma. We studied 21 outpatient asthmatic children (6 girls and 15 boys, mean age 9 yr, range 3–12 yr, all with initial S‐ECP ≥ 15 µg/l) over a period of 12 months at monthly intervals. At each visit a short history, clinical examination, blood sample for S‐ECP and eosinophil count, lung function tests and drug compliance were assessed. According to the initial S‐ECP, patients were allocated to two anti‐inflammatory treatment groups: patients with S‐ECP between 15 µg/l and 30 µg/l were treated with Budesonide 200 µg twice daily, while patients with S‐ECP of 30 µg/l and above received Budesonide 400 µg twice daily. After this induction treatment the anti‐inflammatory medication was tapered at monthly intervals according to actually measured S‐ECP: patients with S‐ECP