Consequences of Discontinuing Inhaled Corticosteroids in Children With Asthma
Early ICS discontinuation can negatively affect lung function and serum eosinophil counts.
Children with well-controlled asthma who discontinue the use of inhaled corticosteroids (ICS) independently may experience worsening symptoms compared with children who did not discontinue ICS, according to a study published in Medicine.
Researchers identified 35 children (mean age, 8±11 years) diagnosed with persistent mild asthma under control and divided them into 2 groups, adherent (n=15) or nonadherent (n=20), based on their retrospectively identified compliance with ICS use during the course of 3 years. There were no significant differences in baseline characteristics between the groups.
Study results demonstrated a decrease in FEV1 (P <.05), FEV1FVC (P <.05), peak expiratory flow (PEF; P <.05), and forced expiratory flow (FEF) 20%-75% (P <.05) in patients who discontinued ICS treatment. When compared with baseline values, significant improvement in provocation concentration of methacholine that produced a 20% decrease in FEV1 was identified in the adherent group, but not in the nonadherent group. In addition, those in the nonadherent group experienced an increase in serum eosinophils (P <.001) and total immunoglobulin E (P <.05) compared with the adherent group.
The investigators concluded that early discontinuation of ICS therapy has a negative effect on lung function, serum eosinophil counts, airway hyperresponsiveness, and total immunoglobulin E levels in children with well-controlled asthma. Therefore, adequate adherence and compliance with ICS treatment is essential for management of persistent mild asthma in children.
Both pediatric patients and parents should be educated about asthma treatment, including the potential effects of discontinuing medication without a physician's approval.
Zheng S, Yu Q, Zeng X, Sun W, Sun Y, Li M. The influence of inhaled corticosteroid discontinuation in children with well-controlled asthma. Medicine (Baltimore). 2017;96:e7848.