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Vol. 37. Issue 2.
Pages 57-62 (April 2009)
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Vol. 37. Issue 2.
Pages 57-62 (April 2009)
ORIGINAL
DOI: 10.1016/S0301-0546(09)71105-X
Effect of inhaled fluticasone on lung function in infants with recurrent wheezing: a randomised controlled trial
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Javier Mallola,
Corresponding author
jmallol@vtr.net

Corresponding author.
, Viviana Aguirrea, Luis Barruetoa, Gustavo Wandalsena, Robert Tepperb
a Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile
b Section of Pediatric Pulmonology, Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University, USA
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Tables (2)
Table I. Baseline characteristics of infants with RW in both study groups
Table II. Lung function values (mean ± SD) in infants with RW treated with inhaled fluticasone or placebo by 3months
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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 (375μg) 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 375μg 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.

KEYWORDS:
Asthma
Infants
Inhaled corticosteroids
Pulmonary function
wheezing

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