October 12, 2000
Inhaled steroids safe and effective for children with asthma
Inhaled corticosteroids are safe and effective for the long-term treatment of children with mild to moderate asthma, according the Childhood Asthma Management Program (CAMP), a five-year, eight-centre study funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health in the United States. The study appears in the October 12, 2000 New England Journal of Medicine.
The Hospital for Sick Children (SickKids) in Toronto is the only Canadian centre participating in CAMP, the longest and largest controlled study of treatments for childhood asthma to date. CAMP showed that inhaled corticosteroids provide superior asthma control. Their only side effect was a temporary one – a small reduction in the children’s rate of growth observed just in the first year of treatment. From evaluation of bone age measured at the end of the study, the ultimate height of the children is expected to be normal. The inhaled corticosteroids significantly reduced airway hyperresponsiveness, the heightened sensitivity in the airways that leads to asthma symptoms following exposure to certain irritants and allergens. However, they did not appear to have an effect on lung growth.
"We have known for some time that inhaled corticosteroids are effective in treating asthma, but before this study, we did not know about the long-term effects of corticosteroid use in children, particularly in terms of growth," said Dr. Ian MacLusky, the co-principal investigator for CAMP at The Hospital for Sick Children. "CAMP confirmed the effectiveness of inhaled corticosteroids while providing reassuring evidence about their safety."
CAMP involved more than 1,000 children ages five to 12 with mild to moderate asthma – 127 children attended the CAMP clinic at The Hospital for Sick Children. The children were randomly assigned to receive either budesonide, an inhaled corticosteroid; nedocromil, a non-steroid anti-inflammatory medication; or a placebo. All children were also provided with a beta-agonist (rescue inhaler) for use, as needed, to relieve symptoms.
"We were honoured to be the only Canadian centre chosen to be part of this landmark study. Asthma is a disease that affects approximately 10 per cent of Canadian children, so it’s important for us to continuously evaluate and improve the treatments we provide," Dr. MacLusky added.
The children involved in CAMP will continue to be observed for another four years, by which time most of the participants will have reached puberty. The results of the continuation study will give a complete picture of the effects of inhaled corticosteroids on both final adult height and maximum adult lung function.
Participating CAMP clinical centres are: Asthma, Inc., Seattle, WA; Bringham and Women’s Hospital, Boston, MA; The Hospital for Sick Children, Toronto, ON; Johns Hopkins Asthma and Allergy Center, Baltimore, MD; National Jewish Medical and Research Center, Denver, CO; University of California and Kaiser Permanente Southern California Region; University of New Mexico, Alburquerque, NM; and Washington University, St. Louis, MO. The CAMP data coordinating centre is Johns Hopkins University.
The medications used in CAMP were donated by AstraZeneca, Wayne, PA; Aventis, Parsippany, NJ; Glaxo Research Institute, Research Triangle Park, NC; and Schering-Plough, Kenilworth, NJ.
The Hospital for Sick Children is a health care, teaching and research centre dedicated exclusively to children; affiliated with the University of Toronto. Its mission is to provide the best in family-centred, compassionate care, to lead in scientific and clinical advancement, and to prepare the next generation of leaders in child health.
For more information, please contact:
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