Inhaled steroids may not control kids' asthma

Daily inhaled steroid therapy is recommended to keep mild-to-moderate asthma from flaring up, but it seems there are children whose condition remains poorly controlled even though they consistently use inhaled steroids.

"We are speculating that it is possible that there are kids who don't respond appropriately to steroid therapy and may in fact have genetic differences that lead to such steroid non-responsiveness," Dr. Gregory Sawicki from Children's Hospital Boston noted in a telephone interview with Reuters Health.

Sawicki reported findings from his group's study on Tuesday at the annual meeting of the American Thoracic Society in San Francisco.
Among 914 children with mild-to-moderate asthma, 425 were prescribed inhaled steroid therapy and 46 percent of them reported consistent inhaler use in the first year. Among children not prescribed inhaled steroid therapy, most reported well-controlled asthma.

After accounting for asthma severity and such, "patients reporting consistent inhaled corticosteroid use over a 1-year period had higher odds of reporting poor asthma control compared to patients reporting no inhaled corticosteroid use," according to Sawicki.

"Although adherence to medication was not assessed and may explain these findings, it is possible that some children have genetic differences that lead to a differential response to inhaled steroid therapy and such differences warrant further study," he told Reuters Health.

In this analysis, all commercially available inhaled corticosteroids were considered together; the researchers did not analyze whether any particular steroid was better than another.