Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations
Inhaled glucocorticoids may prevent a mild loss of asthma control from becoming a full exacerbation. In a randomized trial involving children, quintupling the daily dose at early signs of loss of asthma control did not result in a lower rate of severe asthma exacerbations. Increases in symptoms may...
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| Veröffentlicht in: | The New England journal of medicine 2018-03, Vol.378 (10), p.891-901 |
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| creator | Jackson, Daniel J Bacharier, Leonard B Mauger, David T Boehmer, Susan Beigelman, Avraham Chmiel, James F Fitzpatrick, Anne M Gaffin, Jonathan M Morgan, Wayne J Peters, Stephen P Phipatanakul, Wanda Sheehan, William J Cabana, Michael D Holguin, Fernando Martinez, Fernando D Pongracic, Jacqueline A Baxi, Sachin N Benson, Mindy Blake, Kathryn Covar, Ronina Gentile, Deborah A Israel, Elliot Krishnan, Jerry A Kumar, Harsha V Lang, Jason E Lazarus, Stephen C Lima, John J Long, Dayna Ly, Ngoc Marbin, Jyothi Moy, James N Myers, Ross E Olin, J. Tod Raissy, Hengameh H Robison, Rachel G Ross, Kristie Sorkness, Christine A Lemanske, Robert F |
| description | Inhaled glucocorticoids may prevent a mild loss of asthma control from becoming a full exacerbation. In a randomized trial involving children, quintupling the daily dose at early signs of loss of asthma control did not result in a lower rate of severe asthma exacerbations.
Increases in symptoms may occur before exacerbations fully develop. In two trials, when symptoms occurred, the dose of inhaled glucocorticoids was increased by a factor of 5 (pediatric trial) or 4 (adult trial). There was no benefit, and perhaps some harm, in children, and a modest benefit in adults. |
| doi_str_mv | 10.1056/NEJMoa1710988 |
| format | Article |
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Increases in symptoms may occur before exacerbations fully develop. In two trials, when symptoms occurred, the dose of inhaled glucocorticoids was increased by a factor of 5 (pediatric trial) or 4 (adult trial). There was no benefit, and perhaps some harm, in children, and a modest benefit in adults.</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMoa1710988</identifier><identifier>PMID: 29504498</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Administration, Inhalation ; Albuterol - administration & dosage ; Anti-Asthmatic Agents - administration & dosage ; Anti-Asthmatic Agents - adverse effects ; Asthma ; Asthma - prevention & control ; Child ; Child, Preschool ; Childhood ; Children ; Children & youth ; Diaries ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug dosages ; Female ; Fluticasone ; Fluticasone - administration & dosage ; Fluticasone - adverse effects ; Glucocorticoids ; Growth - drug effects ; Hospitals ; Humans ; Inhalation ; Male ; Medicine ; Peak Expiratory Flow Rate ; Pediatrics ; Propionic acid ; Public health</subject><ispartof>The New England journal of medicine, 2018-03, Vol.378 (10), p.891-901</ispartof><rights>Copyright © 2018 Massachusetts Medical Society. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-7c43a06260bbeb007180c14da711d264d4f3113376cc6fd6f52155b31c5d2aff3</citedby><cites>FETCH-LOGICAL-c511t-7c43a06260bbeb007180c14da711d264d4f3113376cc6fd6f52155b31c5d2aff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMoa1710988$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.nejm.org/doi/full/10.1056/NEJMoa1710988$$EHTML$$P50$$Gmms$$H</linktohtml><link.rule.ids>230,314,776,780,881,2746,2747,26080,27901,27902,52357,54039</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29504498$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jackson, Daniel J</creatorcontrib><creatorcontrib>Bacharier, Leonard B</creatorcontrib><creatorcontrib>Mauger, David T</creatorcontrib><creatorcontrib>Boehmer, Susan</creatorcontrib><creatorcontrib>Beigelman, Avraham</creatorcontrib><creatorcontrib>Chmiel, James F</creatorcontrib><creatorcontrib>Fitzpatrick, Anne M</creatorcontrib><creatorcontrib>Gaffin, Jonathan M</creatorcontrib><creatorcontrib>Morgan, Wayne J</creatorcontrib><creatorcontrib>Peters, Stephen P</creatorcontrib><creatorcontrib>Phipatanakul, Wanda</creatorcontrib><creatorcontrib>Sheehan, William J</creatorcontrib><creatorcontrib>Cabana, Michael D</creatorcontrib><creatorcontrib>Holguin, Fernando</creatorcontrib><creatorcontrib>Martinez, Fernando D</creatorcontrib><creatorcontrib>Pongracic, Jacqueline A</creatorcontrib><creatorcontrib>Baxi, Sachin N</creatorcontrib><creatorcontrib>Benson, Mindy</creatorcontrib><creatorcontrib>Blake, Kathryn</creatorcontrib><creatorcontrib>Covar, Ronina</creatorcontrib><creatorcontrib>Gentile, Deborah A</creatorcontrib><creatorcontrib>Israel, Elliot</creatorcontrib><creatorcontrib>Krishnan, Jerry A</creatorcontrib><creatorcontrib>Kumar, Harsha V</creatorcontrib><creatorcontrib>Lang, Jason E</creatorcontrib><creatorcontrib>Lazarus, Stephen C</creatorcontrib><creatorcontrib>Lima, John J</creatorcontrib><creatorcontrib>Long, Dayna</creatorcontrib><creatorcontrib>Ly, Ngoc</creatorcontrib><creatorcontrib>Marbin, Jyothi</creatorcontrib><creatorcontrib>Moy, James N</creatorcontrib><creatorcontrib>Myers, Ross E</creatorcontrib><creatorcontrib>Olin, J. Tod</creatorcontrib><creatorcontrib>Raissy, Hengameh H</creatorcontrib><creatorcontrib>Robison, Rachel G</creatorcontrib><creatorcontrib>Ross, Kristie</creatorcontrib><creatorcontrib>Sorkness, Christine A</creatorcontrib><creatorcontrib>Lemanske, Robert F</creatorcontrib><creatorcontrib>National Heart, Lung, and Blood Institute AsthmaNet</creatorcontrib><title>Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>Inhaled glucocorticoids may prevent a mild loss of asthma control from becoming a full exacerbation. In a randomized trial involving children, quintupling the daily dose at early signs of loss of asthma control did not result in a lower rate of severe asthma exacerbations.
Increases in symptoms may occur before exacerbations fully develop. In two trials, when symptoms occurred, the dose of inhaled glucocorticoids was increased by a factor of 5 (pediatric trial) or 4 (adult trial). There was no benefit, and perhaps some harm, in children, and a modest benefit in adults.</description><subject>Administration, Inhalation</subject><subject>Albuterol - administration & dosage</subject><subject>Anti-Asthmatic Agents - administration & dosage</subject><subject>Anti-Asthmatic Agents - adverse effects</subject><subject>Asthma</subject><subject>Asthma - prevention & control</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Childhood</subject><subject>Children</subject><subject>Children & youth</subject><subject>Diaries</subject><subject>Dose-Response Relationship, Drug</subject><subject>Double-Blind Method</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Fluticasone</subject><subject>Fluticasone - administration & dosage</subject><subject>Fluticasone - adverse effects</subject><subject>Glucocorticoids</subject><subject>Growth - drug effects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inhalation</subject><subject>Male</subject><subject>Medicine</subject><subject>Peak Expiratory Flow Rate</subject><subject>Pediatrics</subject><subject>Propionic acid</subject><subject>Public health</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp10c1r2zAYBnAxOpYs3XHXYiiFXbzqtSTLvhRCSLuUfmywnYUsybGCLaWSHbr_fg7pSluoLjrox8P76kHoK-DvgFl-fre8vvUSOOCyKD6gKTBCUkpxfoSmGGdFSnlJJuhzjBs8HqDlJzTJSoYpLYspuv01WNcP29a6dbJyjWyNTq7aQXnlQ2-VtzomvU9-BrMzrk8WjW11471O5rFvOpksH6UyoZK99S4eo4-1bKP58nTP0J_L5e_Fj_Tm_mq1mN-kigH0KVeUSJxnOa4qU2HMocAKqJYcQGc51bQmAITwXKm81nnNMmCsIqCYzmRdkxm6OORuh6ozWo2TBdmKbbCdDH-Fl1a8fnG2EWu_E6zkGQM-Bnx7Cgj-YTCxF52NyrStdMYPUWQYcEEJL_b09A3d-CG4cb29KhkZP5WNKj0oFXyMwdTPwwAW-6LEq6JGf_Jyg2f9v5kRnB1A10XhzKZ7J-gf5QaaSQ</recordid><startdate>20180308</startdate><enddate>20180308</enddate><creator>Jackson, Daniel J</creator><creator>Bacharier, Leonard B</creator><creator>Mauger, David T</creator><creator>Boehmer, Susan</creator><creator>Beigelman, Avraham</creator><creator>Chmiel, James F</creator><creator>Fitzpatrick, Anne M</creator><creator>Gaffin, Jonathan M</creator><creator>Morgan, Wayne J</creator><creator>Peters, Stephen P</creator><creator>Phipatanakul, Wanda</creator><creator>Sheehan, William J</creator><creator>Cabana, Michael D</creator><creator>Holguin, Fernando</creator><creator>Martinez, Fernando D</creator><creator>Pongracic, Jacqueline A</creator><creator>Baxi, Sachin N</creator><creator>Benson, Mindy</creator><creator>Blake, Kathryn</creator><creator>Covar, Ronina</creator><creator>Gentile, Deborah A</creator><creator>Israel, Elliot</creator><creator>Krishnan, Jerry A</creator><creator>Kumar, Harsha V</creator><creator>Lang, Jason E</creator><creator>Lazarus, Stephen C</creator><creator>Lima, John J</creator><creator>Long, Dayna</creator><creator>Ly, Ngoc</creator><creator>Marbin, Jyothi</creator><creator>Moy, James N</creator><creator>Myers, Ross E</creator><creator>Olin, J. 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Tod</au><au>Raissy, Hengameh H</au><au>Robison, Rachel G</au><au>Ross, Kristie</au><au>Sorkness, Christine A</au><au>Lemanske, Robert F</au><aucorp>National Heart, Lung, and Blood Institute AsthmaNet</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2018-03-08</date><risdate>2018</risdate><volume>378</volume><issue>10</issue><spage>891</spage><epage>901</epage><pages>891-901</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>Inhaled glucocorticoids may prevent a mild loss of asthma control from becoming a full exacerbation. In a randomized trial involving children, quintupling the daily dose at early signs of loss of asthma control did not result in a lower rate of severe asthma exacerbations.
Increases in symptoms may occur before exacerbations fully develop. In two trials, when symptoms occurred, the dose of inhaled glucocorticoids was increased by a factor of 5 (pediatric trial) or 4 (adult trial). There was no benefit, and perhaps some harm, in children, and a modest benefit in adults.</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>29504498</pmid><doi>10.1056/NEJMoa1710988</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2018-03, Vol.378 (10), p.891-901 |
| issn | 0028-4793 1533-4406 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5972517 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; New England Journal of Medicine |
| subjects | Administration, Inhalation Albuterol - administration & dosage Anti-Asthmatic Agents - administration & dosage Anti-Asthmatic Agents - adverse effects Asthma Asthma - prevention & control Child Child, Preschool Childhood Children Children & youth Diaries Dose-Response Relationship, Drug Double-Blind Method Drug dosages Female Fluticasone Fluticasone - administration & dosage Fluticasone - adverse effects Glucocorticoids Growth - drug effects Hospitals Humans Inhalation Male Medicine Peak Expiratory Flow Rate Pediatrics Propionic acid Public health |
| title | Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T16%3A03%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Quintupling%20Inhaled%20Glucocorticoids%20to%20Prevent%20Childhood%20Asthma%20Exacerbations&rft.jtitle=The%20New%20England%20journal%20of%20medicine&rft.au=Jackson,%20Daniel%20J&rft.aucorp=National%20Heart,%20Lung,%20and%20Blood%20Institute%20AsthmaNet&rft.date=2018-03-08&rft.volume=378&rft.issue=10&rft.spage=891&rft.epage=901&rft.pages=891-901&rft.issn=0028-4793&rft.eissn=1533-4406&rft_id=info:doi/10.1056/NEJMoa1710988&rft_dat=%3Cproquest_pubme%3E2010843787%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2019530015&rft_id=info:pmid/29504498&rfr_iscdi=true |