Ciclesonide versus other inhaled corticosteroids for chronic asthma in children

Kramer, Sharon; Rottier, Bart L.; Scholten, R. J. P. M.; Boluyt, Nicole

doi:10.1002/14651858.cd010352

Cited by 28 publications

(21 citation statements)

References 46 publications

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“…A Cochrane analysis compared ciclesonide with other ICS for children but was inconclusive. 3 The Cochrane analysis that compared small-particle hydrofluoroalkane-beclomethasone and fluticasone for children with asthma was limited because only 2 studies were found. 2 Robroeks et al 20 reported no difference between 12-week therapy with small-particle beclomethasone or fluticasone in either anti-inflammatory effects or clinical outcomes for 33 children with asthma in a small crossover study, although children at study start had normal lung function and generally well-controlled asthma.…”

Section: Discussionmentioning

confidence: 99%

Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

Aalderen

Grigg

Guilbert

et al. 2015

The Journal of Allergy and Clinical Immunology: In Practice

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Section: Discussionmentioning

confidence: 99%

Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

Aalderen

Grigg

Guilbert

et al. 2015

The Journal of Allergy and Clinical Immunology: In Practice

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“…These preparations require once-daily dosing which is believed to contribute to better adherence 42. A Cochrane Review, however, was unable to refute or confirm superiority in terms of asthma control, exacerbations or side effects when comparing ciclesonide to budesonide and fluticasone 43. Symbicort as Maintenance And Reliever Therapy (SMART) dosing regimen has been shown to reduce the risk of severe exacerbations in adults with asthma.…”

Section: Severe Asthma Treatmentmentioning

confidence: 99%

Managing problematic severe asthma: beyond the guidelines

2017

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This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management. Basic asthma management requires optimisation of inhaler technique and treatment adherence, avoidance of environmental triggers and self-management education. It is also important that clinicians recognise risk factors that predispose patients to asthma exacerbations and potentially life-threatening attacks. These correctable issues need to be tackled in partnership with children and young people and their families. This requires a coordinated approach between professionals across healthcare settings. Establishing appropriate infrastructure for coordinated asthma care benefits not only those with problematic severe asthma, but also the wider asthma population as similar correctable issues exist for children with asthma of all severities. Investigation and management of genuine severe asthma requires specialist multidisciplinary expertise and a systematic approach to characterising patients' asthma phenotypes and delivering individualised care. While inhaled corticosteroids continue to play a leading role in asthma therapy, new treatments on the horizon might further support phenotype-specific therapy.

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“…76,77 Though noted to result in improvement in lung function in adult-based studies, a systematic review of studies children aged 4 to 17 years of age could not demonstrate a significant improvement in asthma symptoms using oncedaily ciclesonide compared to twice-daily budesonide administration (risk ratio [RR] 2.20; 95% confidence interval [CI], 0.75 to 6.43). 78 Moreover, concerns have arisen for dose-and duration-dependent adverse effects of daily ICS therapies on linear growth and bone mineral density. 79 Select studies have explored the use of as needed ICS therapies to minimize these concerns.…”

Section: Assessment and Monitoringmentioning

confidence: 99%