Asthma less severe than it was a decade ago

Children today experience milder courses of asthma and require shorter durations of steroid therapy than those in the 1990s, and asthma medications may be the reason, according to a speaker at the Annual Meeting of the American Academy of Allergy, Asthma & Immunology, held in Washington this week.

“Fewer children today require chronically administered prednisone, require less frequent rescue beta agonist therapy, and their baseline forced expiratory volume values are significantly higher than children a decade ago. Whether the natural history of severe asthma has been altered or delayed remains to be determined,” said Joseph Spahn, MD, professor of pediatrics, National Jewish Health at the University of Colorado, Denver.

Spahn and colleagues analyzed the charts of 65 children treated for asthma between 2004 and 2007 and compared them with the charts of 163 children treated between 1993 and 1997. Children in the more recent cohort were generally younger, with a median age of 11.3 years compared with the median age of 14.1 years observed in the historic cohort.

Glucocorticosteriod use declined from 51% to 28% among the two groups. Medication dosages were also lower. Children in the historic cohort averaged 77 puffs of albuterol weekly, children in the more recent cohort averaged 33 puffs.

“With less oral steroid use comes less glucocorticosteriod-associated adverse events,” Spahn said. The researchers observed less growth suppression among the more recent cohort and fewer incidents of myopathy and Cushing’s syndrome compared with patients from the past.

However, body mass index and weight remain elevated in study children compared with healthy children and more than half of children treated with oral steroids continue to have adrenal suppression, according to Spahn. – by Nicole Blazek

For more information:

Spahn J. #242. American Academy of Allergy, Asthma & Immunology Annual Meeting; March 13-17, 2009; Washington.