Effect of inhaled fluticasone on lung function in infants with recurrent wheezing: a randomised controlled trial

Allergol Immunopathol (Madr). Mar-Apr 2009;37(2):57-62. doi: 10.1016/s0301-0546(09)71105-x.

Abstract

Background: Inhaled corticosteroids are used to treat infants with troublesome asthma-like symptoms but their effect on the lung function of these young patients is controversial.

Material and methods: Forty-four infants with recurrent wheezing (more than 3 episodes) and family history of asthma completed this randomised, parallel, double-blind, controlled trial to compare the effect on lung function (main endpoint) of once-daily inhaled fluticasone (375 microg) versus placebo for 3 months. Pulmonary function was measured while infants were asymptomatic, using the raised volume rapid thoracic compression technique (spirometry-like), and values were converted to z-scores.

Results: The fluticasone group showed a significant increase in forced flows, (p < 0.001), a lower number of physician diagnosed wheezing episodes (p < 0.002), and a significant decrease in the parent-reported number of wheezing episodes per month (p < 0.03), as compared to placebo. One third of parents in the placebo group reported a clinical improvement in their infants. There was no significant difference in morning plasma cortisol between groups at entry or discharge.

Conclusions: We conclude that once-daily treatment with 375 microg fluticasone increased forced flows and controlled symptoms in infants with recurrent wheezing without altering plasma cortisol levels. The spirometry-like technique is a useful tool to objectively assess the efficacy of anti-asthma medications in infants with repeated troublesome asthma-like symptoms.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Androstadienes / administration & dosage*
  • Androstadienes / adverse effects
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / adverse effects
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Case-Control Studies
  • Double-Blind Method
  • Female
  • Fluticasone
  • Forced Expiratory Volume / drug effects
  • Humans
  • Infant
  • Lung / drug effects*
  • Lung / physiopathology
  • Male
  • Recurrence
  • Respiratory Sounds / drug effects*
  • Respiratory Sounds / immunology

Substances

  • Androstadienes
  • Anti-Inflammatory Agents
  • Fluticasone