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One year treatment with salmeterol compared with beclomethasone in children with asthma. The Dutch Paediatric Asthma Study Group.

Abstract

The aim of this study was to compare the effects of salmeterol and beclomethasone on lung function and symptoms in children with mild to moderate asthma. Sixty-seven children not treated with inhaled corticosteroids were randomized in a double-blind parallel study either to salmeterol 50 micrograms b.i.d. or beclomethasone 200 micrograms b.i.d. After one year, FEV1 significantly increased in the beclomethasone group, whereas in the salmeterol group there was a small reduction. Differences between groups were 14.2% predicted (p < 0.0001) and 7.0% predicted (p = 0.007) for pre- and postbronchodilator FEV1 values, respectively. PD20 methacholine decreased by 0.73 DD (p = 0.05) in the salmeterol group and increased by 2.02 DD (p < 0.0001) in the beclomethasone group. Morning and evening PEF and symptom scores improved in both groups, although more in the beclomethasone group. Asthma exacerbations, for which prednisolone was needed, were more frequent in the salmeterol group (17 versus two), as were the number of withdrawals due to exacerbations (six versus one). However, growth was significantly slower in the beclomethasone group (-0.28 SDS) compared with that in the salmeterol group (-0.03 SDS) (p = 0.001). We conclude that treatment with a moderate dose of beclomethasone is superior to salmeterol in children with mild to moderate asthma and recommend that salmeterol should not be used as monotherapy.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, Erasmus University, Rotterdam, The Netherlands.

    , , ,

    Source

    MeSH

    Adolescent
    Adrenergic beta-Agonists
    Albuterol
    Asthma
    Beclomethasone
    Body Height
    Bronchial Provocation Tests
    Bronchodilator Agents
    Child
    Double-Blind Method
    Female
    Follow-Up Studies
    Forced Expiratory Volume
    Humans
    Male
    Peak Expiratory Flow Rate
    Salmeterol Xinafoate
    Severity of Illness Index
    Vital Capacity

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    9309980

    Citation

    Verberne, A A., et al. "One Year Treatment With Salmeterol Compared With Beclomethasone in Children With Asthma. the Dutch Paediatric Asthma Study Group." American Journal of Respiratory and Critical Care Medicine, vol. 156, no. 3 Pt 1, 1997, pp. 688-95.
    Verberne AA, Frost C, Roorda RJ, et al. One year treatment with salmeterol compared with beclomethasone in children with asthma. The Dutch Paediatric Asthma Study Group. Am J Respir Crit Care Med. 1997;156(3 Pt 1):688-95.
    Verberne, A. A., Frost, C., Roorda, R. J., van der Laag, H., & Kerrebijn, K. F. (1997). One year treatment with salmeterol compared with beclomethasone in children with asthma. The Dutch Paediatric Asthma Study Group. American Journal of Respiratory and Critical Care Medicine, 156(3 Pt 1), pp. 688-95.
    Verberne AA, et al. One Year Treatment With Salmeterol Compared With Beclomethasone in Children With Asthma. the Dutch Paediatric Asthma Study Group. Am J Respir Crit Care Med. 1997;156(3 Pt 1):688-95. PubMed PMID: 9309980.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - One year treatment with salmeterol compared with beclomethasone in children with asthma. The Dutch Paediatric Asthma Study Group. AU - Verberne,A A, AU - Frost,C, AU - Roorda,R J, AU - van der Laag,H, AU - Kerrebijn,K F, PY - 1997/10/6/pubmed PY - 1997/10/6/medline PY - 1997/10/6/entrez SP - 688 EP - 95 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 156 IS - 3 Pt 1 N2 - The aim of this study was to compare the effects of salmeterol and beclomethasone on lung function and symptoms in children with mild to moderate asthma. Sixty-seven children not treated with inhaled corticosteroids were randomized in a double-blind parallel study either to salmeterol 50 micrograms b.i.d. or beclomethasone 200 micrograms b.i.d. After one year, FEV1 significantly increased in the beclomethasone group, whereas in the salmeterol group there was a small reduction. Differences between groups were 14.2% predicted (p < 0.0001) and 7.0% predicted (p = 0.007) for pre- and postbronchodilator FEV1 values, respectively. PD20 methacholine decreased by 0.73 DD (p = 0.05) in the salmeterol group and increased by 2.02 DD (p < 0.0001) in the beclomethasone group. Morning and evening PEF and symptom scores improved in both groups, although more in the beclomethasone group. Asthma exacerbations, for which prednisolone was needed, were more frequent in the salmeterol group (17 versus two), as were the number of withdrawals due to exacerbations (six versus one). However, growth was significantly slower in the beclomethasone group (-0.28 SDS) compared with that in the salmeterol group (-0.03 SDS) (p = 0.001). We conclude that treatment with a moderate dose of beclomethasone is superior to salmeterol in children with mild to moderate asthma and recommend that salmeterol should not be used as monotherapy. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/9309980/full_citation L2 - http://www.atsjournals.org/doi/full/10.1164/ajrccm.156.3.9611067?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -