650:
Comparative efficacy of daily inhaled fluticasone propionate and episodic inhaled combined salmeterol/fluticasone propionate in children with recurrent wheezing
Monday, March 5, 2018
South Hall A2 (Convention Center)
Jiratchaya Chamnanrua, MD, Tassalapa Daengsuwan, MD
RATIONALE:

Daily inhaled corticosteroid (ICS) is recommended by the world expert committee to treat patients with persistent asthma and tendency to have asthma as a controller. However, many children in Thailand tend to receive episodic inhaled corticosteroid due to their parents’ inconvenience. We compare efficacy of daily inhaled fluticasone propionate (IFP) and episodic inhaled combined salmeterol/fluticasone propionate (ISFP) in children with recurrent wheezing.

METHODS:

Forty-four children aged 1 to 15, with recurrent wheezing and tendency to have asthma were recruited in our study. Participants were randomized to receive either daily IFP (N=24) or 14-day of ISFP started at the onset of symptoms of respiratory tract illness (N=20). The primary outcome was the percentage of exacerbations which needed systemic corticosteroid. The secondary outcome was the monthly height rate. Proportional-hazards regression model and ANOVA were used for statistical analysis.

RESULTS:

At 6 months after the treatment, the percentage of exacerbations which needed systemic corticosteroid between 2 groups had no statistically significant difference (P=0.790) with hazard ratio of 1.224 (95% confidence interval (CI) 0.278 to 5.392). Monthly height rate also had no significant difference (P=0.869), 0.66 (95% CI 0.56 to 0.76) centimeters (cm) in daily IFP and 0.67 (95% CI 0.56 to 0.78) cm in episodic ISFP. Median cumulative ICS dose in daily IFP group (45,000 micrograms) and episodic ISFP group (5,250 micrograms) was significantly different (P<0.001). No adverse event was found in episodic ISFP group.

CONCLUSIONS:

There were no significant difference in reducing exacerbation and height suppression between daily IFP and episodic ISFP in 6-month period.