Asthma meds aren't one-size-fits-all

By Lisa Applegate
Tuesday, April 27, 2010

Though children with low to moderate asthma are typically treated with the same medication, few children have the same responses to it.

That's the finding of new research, funded by the National Institutes of Health, that studied children age 6-18 with asthma. The research found that 98 percent of children responded differently to three of the most typically used treatments.

The findings provide essential information for doctors trying to select the best option for young patients, says the paper's lead author, Dr. Robert F. Lemanske from the University of Wisconsin Hospital-Madison. Previously, he says, most of the research on asthma medications for kids has been conducted by pharmaceutical companies that compared one drug with a placebo.

Usually, children with moderate asthma are given an inhaled corticosteroid first. If it doesn't work, doctors then follow NIH guidelines to either double the corticosteroid dose or add either a long-acting beta-agonist or a leukotriene receptor antagonist.

If one of those additions doesn't work, Lemanske says, doctors sometimes rate a child's asthma as more severe and prescribe more steroids. But the study found that the child may simply need to try another of the three NIH-recommended options.

"It's not a one-size-fits-all," he says. "What makes it challenging for clinicians is that what works for Johnny may not work for Mary. That's why follow-up care is so important as well."

According to the Centers for Disease Control and Prevention, asthma affects 7 million children and is a major cause of school absenteeism. Lemanske says boys under 10 are twice as likely as girls to develop asthma, but girls catch up by adolescence. Finding out why will be the goal of future studies, he says.

This article appeared in the May 2010 edition of Chicago Parent.