NIH Record - National Institutes of Health

Increases in Inhaled Steroids Don’t Prevent Asthma Flare-Ups

Boy using an asthma inhaler while holding a football outside.
Temporarily increasing the dosage of inhaled steroids when asthma symptoms worsen does not prevent severe flare-ups.

Photo:  CT757fan/iStock

Researchers have found that temporarily increasing the dosage of inhaled steroids when asthma symptoms begin to worsen does not effectively prevent severe flare-ups and may be associated with slowing a child’s growth. This challenges a common medical practice involving children with mild to moderate asthma.  

The study, funded by NHLBI, appeared Mar. 8 in the New England Journal of Medicine.

Asthma flare-ups in children are common and costly. To prevent them, many health professionals recommend increasing the doses of inhaled steroids from low to high at early signs of symptoms such as coughing, wheezing and shortness
of breath. 

Until now, researchers had not rigorously tested the safety and efficacy of this strategy in children with mild-to-moderate asthma.

“These findings suggest that a short-term increase to high-dose inhaled steroids should not be routinely included in asthma treatment plans for children with mild-moderate asthma who are regularly using low-dose inhaled corticosteroids,” said study leader Dr. Daniel Jackson of the University of Wisconsin School of Medicine and Public Health. “Low-dose inhaled steroids remain the cornerstone of daily treatment in affected children.”

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