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Centre de recherche
Thursday, January 22 2009
Press release

A New Treatment reduces the severity of asthma attacks in preschool-aged children.

Montreal, January 22, 2009 - A research team led by Dr. Francine Ducharme, Associate Director of Clinical Research at the CHU Sainte-Justine Research Center and Professor at the Department of Pediatrics, Université de Montréal, has demonstrated the efficacy of a preventive treatment with high doses of inhaled corticosteroids in reducing the severity and duration of asthma attacks triggered by colds in preschool-aged children.

Her research findings, published today in the New England Journal of Medicine, show that high doses of these corticosteroids (fluticasone) when inhaled at the onset of a cold and taken for up to 10 days contribute to reducing the number of moderate or severe asthma attacks that require emergency oral steroids. This is the largest study conducted on the subject to date.

This is also the first study whose findings clearly demonstrate the treatment’s efficacy in young children who had required oral corticosteroids or hospital admission because of the severity of their attacks. The breakthrough is all the more important, since this age group represents more than half (60%) of the children that go to Emergency Departments or are admitted to hospital for asthma attacks.

Although viral-induced asthma is frequent in preschool-aged children, optimal management of this disease still remains elusive. This is why Dr. Ducharme has been focusing on improving treatment for asthmatic children, particularly those of preschool age.

The basic treatment for asthma, which consists of administering weak doses of inhaled steroids such as fluticasone, on a daily basis, has not proven to be effective in children with viral-induced asthma.

For the purposes of the study, 2243 children were tested and 17% of the children met the criteria of having asthma triggered solely by colds, without experiencing asthma symptoms between colds or having any signs of allergy, and of suffering from moderate to severe asthma attacks. The new therapeutic approach was studied in 129 children one to six years old. By increasing the usual pediatric dose six fold over a maximum of 10 days and beginning administration as soon as colds started, the team noted a 50% decrease in asthma attacks that required oral steroids in children. A 20% reduction in the duration of the illness was also noted. The researcher was able to note that the children who had received fluticasone had milder symptoms of shorter duration compared with the placebo group, thereby reducing the impact of the disease on the parents’ quality of life.

The researchers were not only interested in evaluating the efficacy of the treatment but also its side-effect profile. Over the 40-week monitoring period, Dr. Ducharme also observed a slightly slower growth rate (4%) in this group of children than in the placebo group. In fact, the findings indicate that the average growth rate of the untreated children was about 6.5 cm as opposed to 6.0 cm in the children treated with fluticasone. This corresponds to what is seen when patients take the usual daily dose of fluticasone over 12 months. A slower average weight gain was also noted in the children taking the placebo (approximately 2 kg) than in the children treated with corticosteroids (1.5 kg). Since this type of asthma is temporay and usually disappears before the age of 6, the treatment probably has a transient effect on growth. For the research team, it remains to be confirmed whether the children will be able to make up for this slight growth delay.

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For information

CHU Sainte-Justine
Nicole Saint-Pierre
Communications Advisor
CHU Sainte-Justine
(514) 345-4931, Ext. 2555

Media Relations: Mélanie Dallaire
Communications Advisor – Media Relations
CHU Sainte-Justine

Sylvain-Jacques Desjardins
International Press Attaché
University of Montreal
Tel.: (514) 343-7593
Cell: (514) 710-7819

Persons mentioned in the text

About the study:
The study was funded by GlaxoSmithKline, the Fonds de la Recherche en Santé du Québec (FRSQ) and the Canadian Institutes of Health Research and conducted at the CHU Sainte-Justine, the McGill University Health Center, the CHU Sherbrooke, Maisonneuve-Rosemont Hospital and La courte Échelle Pediatric Clinic.

About the CHU Sainte-Justine:
The Sainte-Justine University Hospital Center is the largest mother-child center in Canada and one of the four most important pediatric centers in North America. Sainte-Justine employs more than 4,000 people. Affiliated with the University of Montreal, the CHU Sainte-Justine is by far the largest pediatric training center in Quebec and it plays a leading role in Canada. Its Research Center has 178 investigators and more than 400 students. It is a recognized leader in many fields including perinatology, neurodevelopment, cardiac sciences, hemato-immuno-oncology, musculoskeletal disorders, movement sciences and health promotion. Sainte-Justine celebrated its centenary in 2007. www.chusj.org

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