Current Approaches to the Choice of Basic Therapy for Mild Persistent Bronchial Asthma in Children

• Main Authors: S.M. Nedelska, O.D. Kuznietsova, K.V. Raskina
• Format: Article
• Language: English
• Published: Publishing House Zaslavsky 2015-03-01
• Series: Zdorovʹe Rebenka
• Subjects: bronchial asthma; inhaled glucocorticosteroids; leukotrien modifiers; children.
• Online Access: http://childshealth.zaslavsky.com.ua/article/view/75067
• ISSN: 2224-0551; 2307-1168

Objective of the Study: improving the treatment of mild persistent bronchial asthma based on the development of differential program for antiinflammatory therapy. Of 120 children we have formed 3 groups depending on the effective basic therapy (leukotrien modifier, fluticasone propionate or their combination), which made it possible to achieve control of the disease. Results. The highest concentrations of leukotrienes in blood serum were observed in children of the 3rd group, they were higher even after treatment, than in children from the control group. At the level of leukotrienes from 500 to 1000 pg/ml chances of achieving bronchial asthma control using leukotrien modifier were 5.9 times higher compared with inhaled glucocorticosteroids (CI95% 2.01–18.2). And when the level of leukotrienes (C4/D4/E4) exceeded 1000 pg/ml, combination therapy is more effective than treatment with leukotrien modifier (odds ratio (OR) = 6.7; CI95% 2.5–17.8) and fluticasone propionate (OR = 83.3; CI95% 9.9–667.9). Conclusions. Leukotrien modifier as monotherapy is indicated to 6–7-year-old children with mild persistent bronchial asthma and serum levels of leukotrienes from 500 to 1000 pg/ml. At the level of leukotrienes below 500 pg/ml it is advisable to administer fluticasone propionate, above 1000 pg/ml — combination of leukotrien modifier and inhaled corticosteroid.