TY - JOUR
T1 - Patient characteristics associated with improved outcomes with use of an inhaled corticosteroid in preschool children at risk for asthma
AU - Bacharier, Leonard B.
AU - Guilbert, Theresa W.
AU - Zeiger, Robert S.
AU - Strunk, Robert C.
AU - Morgan, Wayne J.
AU - Lemanske, Robert F.
AU - Moss, Mark
AU - Szefler, Stanley J.
AU - Krawiec, Marzena
AU - Boehmer, Susan
AU - Mauger, David
AU - Taussig, Lynn M.
AU - Martinez, Fernando D.
N1 - Funding Information:
Disclosure of potential conflict of interest: L. B. Bacharier has received honoraria from AstraZeneca, Genentech, GlaxoSmithKline, Merck, and Aerocrine and has served on the advisory board for Schering-Plough. T. W. Guilbert has received honoraria from GlaxoSmithKline, AstraZeneca, PeerPoint Medical Education Institute, Merck, and Antidote; has received research support from Altus Pharmaceuticals, Inspire Pharmaceuticals, and the National Institutes of Health; and is a member of the American Lung Association, the American Thoracic Society, and the American Academy of Pediatrics. R. S. Zeiger has served as a consultant for Aerocrine, AstraZeneca, Dynavax, Genentech, GlaxoSmithKline, Merck, Novartis, and Schering-Plough and has received research support from AstraZeneca, GlaxoSmithKline, Genentech, Merck, the National Heart, Lung, and Blood Institute, Sanofi-aventis, and TEVA Pharmaceuticals. W. J. Morgan has served as a consultant for the Cystic Fibrosis Foundation and Genentech and has received research support from the National Institutes of Health/University of Wisconsin. R. F. Lemanske, Jr, has received honoraria as a speaker for Merck, has served as a consultant for GlaxoSmithKline, and has received research support from the National Heart, Lung, and Blood Institute. M. Moss served as the president of the Wisconsin Allergy Society from 2005 to 2007. S. J. Szefler has served as a consultant for AstraZeneca, GlaxoSmithKline, Aventis, Genentech, Merck and has received research support from the National Institutes of Health/National Heart, Lung, and Blood Institute Childhood Asthma Management Program, the National Heart, Lung, and Blood Institute Childhood Asthma Research and Education, the National Institutes of Health/National Heart, Lung, and Blood Institute Asthma Clinical Research Network, the National Institutes of Health/National Institute of Allergy and Infectious Diseases Inner City Asthma Consortium, and Ross Pharmaceuticals. M. Krawiec has served on the speakers' bureau for Merck and GlaxoSmithKline and as a consultant for Novartis, has received research support from the American Lung Association, and has served as an expert witness for Parexel. F. D. Martinez has served on the advisory board for Merck, has received lecture fees from Merck and Pfizer, and has served as a consultant for GlaxoSmithKline and MedImmune. The rest of the authors have declared that they have no conflict of interest.
PY - 2009/5
Y1 - 2009/5
N2 - Background: Maintenance inhaled corticosteroid (ICS) therapy in preschool children with recurrent wheezing at high-risk for development of asthma produces multiple clinical benefits. However, determination of baseline features associated with ICS responsiveness may identify children most likely to benefit from ICS treatment. Objective: To determine if demographic and atopic features predict response to ICS in preschool children at high risk for asthma. Methods: Two years of treatment with an ICS, fluticasone propionate (88 μg twice daily), was compared with matching placebo in a double-masked, randomized, multicenter study of 285 children 2 and 3 years old at high risk for asthma development. Baseline demographic and atopic features were related to clinical outcomes in a post hoc subgroup analysis. Results: Multivariate analysis demonstrated significantly greater improvement with fluticasone than placebo in terms of episode-free days among boys, white subjects, participants with an emergency department (ED) visit or hospitalization within the past year, and those who experienced more symptomatic days at baseline. Children with aeroallergen sensitization experienced greater benefits in terms of oral corticosteroid use, urgent care and ED visits, and use of supplemental controller medications. Conclusions: More favorable responses to ICS than placebo in high-risk preschool children over a 2-year period were more likely in those with a ED visit or hospitalization for asthma within the past year, children with aeroallergen sensitization, boys, and white subjects.
AB - Background: Maintenance inhaled corticosteroid (ICS) therapy in preschool children with recurrent wheezing at high-risk for development of asthma produces multiple clinical benefits. However, determination of baseline features associated with ICS responsiveness may identify children most likely to benefit from ICS treatment. Objective: To determine if demographic and atopic features predict response to ICS in preschool children at high risk for asthma. Methods: Two years of treatment with an ICS, fluticasone propionate (88 μg twice daily), was compared with matching placebo in a double-masked, randomized, multicenter study of 285 children 2 and 3 years old at high risk for asthma development. Baseline demographic and atopic features were related to clinical outcomes in a post hoc subgroup analysis. Results: Multivariate analysis demonstrated significantly greater improvement with fluticasone than placebo in terms of episode-free days among boys, white subjects, participants with an emergency department (ED) visit or hospitalization within the past year, and those who experienced more symptomatic days at baseline. Children with aeroallergen sensitization experienced greater benefits in terms of oral corticosteroid use, urgent care and ED visits, and use of supplemental controller medications. Conclusions: More favorable responses to ICS than placebo in high-risk preschool children over a 2-year period were more likely in those with a ED visit or hospitalization for asthma within the past year, children with aeroallergen sensitization, boys, and white subjects.
KW - Childhood asthma
KW - inhaled corticosteroids
KW - response
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U2 - 10.1016/j.jaci.2008.12.1120
DO - 10.1016/j.jaci.2008.12.1120
M3 - Article
C2 - 19230959
AN - SCOPUS:67349174723
VL - 123
SP - 1077-1082.e5
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
SN - 0091-6749
IS - 5
ER -