Studies challenge use of steroids for kids

Say treatment for wheezing no help

Giving steroids to children who are wheezing because of viral or other infections does not help, researchers reported yesterday.

And an experimental treatment designed to prevent wheezing may be effective, but it seems to pose too many risks to be recommended, according to studies published in the New England Journal of Medicine.

About one-third of preschool children develop wheezing, which can worry parents. At least 75 percent outgrow the problem by age 6. In the past, doctors have treated it as they would asthma, which is why they often use corticosteroids.

"It is clear that on the basis of these two studies, current practice must change," Dr. Andrew Bush of the Imperial School of Medicine and Royal Brompton Hospital in London wrote in a commentary.

Dr. Jonathan Grigg of Queen Mary University in London and colleagues found that children given five days of the steroid prednisolone stayed just as long in hospital as children given a placebo. They tested nearly 700 children aged 10 months to 5 years old.

The second study compared GlaxoSmithKline's Flovent, available generically as fluticasone, with a placebo in 129 children aged 1 to 6 years. The children were treated twice daily for up to 10 days.

The drug seemed to help, Dr. Francine Ducharme of the Centre Hospitalier Universitaire in Montreal and colleagues reported.

While 18 percent of the youngsters in the placebo group needed further treatment with steroid drugs, the rate was 8 percent for those who got Flovent.

But the children who got Flovent tended to grow less - a tenth of an inch less over nearly 10 months - than those getting a placebo.

GlaxoSmithKline, which helped fund the study, released a statement saying that the dose of Flovent was well above the recommended range for treating asthma in children of that age, and noting that the drug is not approved for treating wheezing.