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Episodic use of an inhaled corticosteroid or leukotriene receptor antagonist in preschool children with moderate-to-severe intermittent wheezing

Open access
Bacharier, Leonard B., Phillips, Brenda R., Zeiger, Robert S., Szefler, Stanley J., Martinez, Fernando D., Lemanske, Robert F., Sorkness, Christine A., Bloomberg, Gordon R., Morgan, Wayne J., Paul, Ian M., Guilbert, Theresa, Krawiec, Marzena, Covar, Ronina, Larsen, Gary, Mellon, Michael, Moss, Mark H., Chinchilli, Vernon M., Taussig, Lynn M., Strunk, Robert C.·2008·Journal of Allergy and Clinical Immunology

Abstract

Background Acute wheezing illnesses in preschoolers need better management strategies to reduce morbidity. Objectives To examine the effectiveness of episodic use of an inhaled corticosteroid and a leukotriene receptor antagonist in preschoolers with intermittent wheezing. Methods In a randomized, double-blind placebo-controlled twelve-month trial, 238 children aged 12-59 months with moderate-severe intermittent wheezing received 7-days of either budesonide inhalation suspension (1mg twice daily), montelukast (4mg daily), or placebos in addition to albuterol with each identified respiratory tract illness. Proportion of episode-free days (EFDs) during the 12-month trial was the primary outcome. Results The three treatment groups did not differ in proportions of EFDs, with adjusted mean (95% CI) EFDs of 76% (70%, 81%) for budesonide, 73% (66%, 79%) for montelukast, and 74% (65%, 81%) for conventional therapy (p=0.66). The three groups did not differ in oral corticosteroid use, health care utilization, quality of life, or linear growth. However, during respiratory tract illnesses, budesonide and montelukast therapy led to modest reductions in trouble breathing [(38% (p=0.003) and 37% (p=0.003)] and interference with activity scores [32% (p=0.01) and 40% (p=0.001)], most evident in those with positive asthma predictive indices. Conclusions In preschool children with moderate-to-severe intermittent wheezing, episodic use of either budesonide or montelukast early in respiratory tract illnesses, when added to albuterol, did not increase the proportion of EFDs or decrease oral corticosteroid use over a twelve-month period. However, indicators of severity of acute illnesses were reduced, particularly in children with positive asthma predictive indices. Capsule Summary The episodic use of budesonide or montelukast in preschool children with moderate-to-severe intermittent wheezing does not increase the proportion of episode free days, but decreases symptom severity during acute respiratory tract illnesses.

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Metadata

Authors
Bacharier, L. B., Phillips, B. R., Zeiger, R. S., Szefler, S. J., Martinez, F. D., Lemanske, R. F., Sorkness, C. A., Bloomberg, G. R., Morgan, W. J., Paul, I. M., Guilbert, T., Krawiec, M., Covar, R., Larsen, G., Mellon, M., Moss, M. H., Chinchilli, V. M., Taussig, L. M., & Strunk, R. C.
Venue
Journal of Allergy and Clinical Immunology
Publisher
Elsevier BV
Published
2008-12
Volume
122
Issue
6
Pages
1127-1135.e8
ISSN
0091-6749 (ISSN-L)
OpenAlex
W2030827695
Cited by
270
References
26
FWCI
16.89
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Episodic use of an inhaled corticosteroid or leukotriene receptor antagonist in preschool children with moderate-to-severe intermittent wheezing. https://app.cochat.ai/papers/10.1016/j.jaci.2008.09.029
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Bacharier, L. B., Phillips, B. R., Zeiger, R. S., Szefler, S. J., Martinez, F. D., Lemanske, R. F., Sorkness, C. A., Bloomberg, G. R., Morgan, W. J., Paul, I. M., Guilbert, T., Krawiec, M., Covar, R., Larsen, G., Mellon, M., Moss, M. H., Chinchilli, V. M., Taussig, L. M., & Strunk, R. C. (2008). Episodic use of an inhaled corticosteroid or leukotriene receptor antagonist in preschool children with moderate-to-severe intermittent wheezing. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2008.09.029

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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