Cochrane for Clinicians

Putting Evidence into Practice

Intermittent Inhaled Corticosteroid Therapy for Mild Persistent Asthma in Children and Adults

 


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Am Fam Physician. 2016 Jul 1;94(1):21-22.

Clinical Question

Is the use of intermittent inhaled corticosteroid therapy safe and effective for mild persistent asthma in children and adults?

Evidence-Based Answer

Intermittent inhaled corticosteroid therapy reduces the risk of asthma exacerbations in children and adults with mild persistent asthma. Intermittent use appears to be safe in these patients. (Strength of Recommendation: B, based on limited-quality evidence from randomized controlled trials.)

Practice Pointers

Asthma accounts for 14.2 million office visits to U.S. physicians (1.4% of all encounters) each year and is responsible for significant respiratory-associated morbidity and mortality.1 Symptoms such as wheezing, cough, and dyspnea can vary in timing and intensity. Clinical management includes quantifying asthma severity and providing patient education, environmental control, and stepwise treatment with medications, if required.2 Daily inhaled corticosteroid therapy for children and adults is recognized as standard treatment for persistent asthma.2 However, for patients with mild persistent asthma symptoms, optimal inhaled corticosteroid use has not been determined. This Cochrane review studied whether intermittent inhaled corticosteroids initiated at the time of

Author disclosure: No relevant financial affiliations.

REFERENCES

1. Centers for Disease Control and Prevention. National Ambulatory Medical Care Survey: 2010 summary tables. http://www.cdc.gov/nchs/data/ahcd/namcs_summary/2010_namcs_web_tables.pdf. Accessed September 15, 2015.

2. National Asthma Education and Prevention Program Expert Panel Report 3. Guidelines for the diagnosis and management of asthma: summary report 2007. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/files/docs/guidelines/asthsumm.pdf. Accessed September 11, 2015.

3. Chauhan BF, Chartrand C, Ducharme FM. Intermittent versus daily inhaled corticosteroids for persistent asthma in children and adults. Cochrane Database Syst Rev. 2013;(2):CD009611.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, Assistant Medical Editor.

A collection of Cochrane for Clinicians published in AFP is available at http://www.aafp.org/afp/cochrane.



 

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