Inhaled Corticosteroid-Long-Acting Beta-2 Agonist Fixed-Dose Combinations: Preferred Controller in 6- to 11-Year-Olds with Persistent Asthma.

Abstract

Introduction: So far, there is no direct comparison between inhaled corticosteroid (ICS) monotherapy and ICS-long-acting beta-2 agonists (LABA) fixed-dose combination therapies in 6- to 11-year-old children with persistent asthma. The primary objective of this study was to compare ICS monotherapy and ICS-LABA fixed-dose combination therapies for the frequency of exacerbations requiring systemic corticosteroids (CS).

Methods: Patients aged 6-11 years diagnosed with persistent asthma during steps 2-4 of treatment, prescribed daily ICS-containing treatment (fluticasone propionate [FP], fluticasone propionate/salmeterol [FP/SAL], and budesonide/formoterol [BUD/F]), and followed for at least 1 year at our institution from January 2021 to January 2024 were included. The hospital's electronic database was used to retrospectively record asthma controller medication, frequency of asthma exacerbations (including those requiring systemic CS, emergency department [ED] visit and/or hospitalization) and pneumonia.

Results: The frequency of all exacerbations, exacerbations requiring systemic CS, and exacerbations requiring ED visit/hospitalization were significantly higher in the FP group compared to the FP/SAL and BUD/F groups (p < 0.001, p = 0.003, p < 0.001, respectively). There were no significant differences between the FP/SAL and BUD/F groups concerning all exacerbation parameters (p > 0.05). The incidence of pneumonia was very low in the fixed-dose combination groups, making a statistical comparison unfeasible.

Conclusion: ICS-LABA fixed-dose combination therapies have been found to be more effective than ICS monotherapy in preventing asthma exacerbations in 6-11-year-old children with persistent asthma and could be recommended as the preferred controllers.