ICS favors long-term outcome in childhood asthma

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ICS favors long-term outcome in childhood asthma

• Dr. Gautam Sadhukhan

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INDUCERS Maternal smoking, Chemicals, Air
pollutants, Virus infections
Inhaled CORTICOSTEROIDS
Genetic propensity
Airway Hyperresponsiveness
Airflow Limitation
TRIGGERS Allergens, Exercise Cold Air, SO2
Particulates
SYMPTOMS
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Inflammation in asthma
ICS
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PEP Talk
Natural history of asthma

• 2 out of 3 children with asthma outgrow their
  symptoms
• Risk factors for asthma persisting into adulthood
• Female
• Eczema
• Onset after age of 3 years
• Severe disease
• Parental history of atopy / asthma

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Methacholine Challenge Test CAMP study NEJM 2000
Methach. Requ. To Produce Fall In FEV1
ICS
Placebo
Time 4 to 6 years
Airway Hyper responsiveness
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MLord Hable Juries

• ICS specifically inhibit inflammation so long it
  is used! (NHLBI GINA Studies, 1997-2002)
• Airway hyper-responsiveness. Definite
  improvement (CAMP study NEJM 2000)
• All wheezers improve in both acute and chronic
  symptoms. (Martinez FD Pediatrics 2002).
• Airway remodelling may be preventable if ICS are
  used in right time and duration (Bisgaard. H. Am
  J Resp Care 1996)