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Benefits and Risks of Long-Term Asthma Management in Children: Where Are We Heading?

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Abstract

International guidelines provide recommendations for a stepwise approach to the management of asthma in children 0–4 years old, 5–11 years old, and adolescents who are treated as adults. Therapy is aimed at two domains of control: current impairment and future risk. The long-term controller medications, inhaled corticosteroids (ICSs), ICSs in combination with long-acting β2 agonists, leukotriene receptor antagonists, and immunomodulators, exhibit different efficacies for these domains. The risk:benefit ratios of the available medications need to be carefully assessed. This review briefly presents the benefits and the potential risks of available asthma medications in children to assist the practitioner in the optimal use of asthma medications. Specifically, the systemic activity of the ICSs and how to minimize their effects on growth and adrenal activity are reviewed as well as other potential adverse effects. Dosing strategies such as intermittent therapy are also assessed.

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Authors and Affiliations

  1. Department of Pediatrics, MSC10 5590, University of New Mexico, School of Medicine, 1 University of New Mexico, Albuquerque, NM, 87131, USA

    Hengameh H. Raissy & H. William Kelly

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  1. Hengameh H. Raissy
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  2. H. William Kelly
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Correspondence to Hengameh H. Raissy.

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Conflict of interest

H. William Kelly discloses the following activities: he was the Principal Investigator for the University of New Mexico site of the CAMP (Childhood Asthma Management Program) study from November 1999 to June 2011; he is currently a member of the independent Joint Oversight Committee for the four FDA-mandated LABA/ICS safety trials by AstraZeneca, GlaxoSmithKline, Merck, and Novartis and the Steering Committee for the Pediatric LABA/ICS study by GlaxoSmithKline. Hengameh Raissy discloses the following activities: she was the principal investigator for the University of New Mexico site for the CAMP Study from July 2011 to June 2012, Childhood Asthma Research Education (CARE) network 3/08-10/10 and AsthmaNet 3/11-present.

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Raissy, H.H., Kelly, H.W. Benefits and Risks of Long-Term Asthma Management in Children: Where Are We Heading?. Drug Saf 40, 201–210 (2017). https://doi.org/10.1007/s40264-016-0483-0

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