Asthma: how early to start using inhaled steroids?

V Madden
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Abstract

Using inhaled steroids to prevent inflammation is a standard part of treatment for moderate to severe asthma. The "early intervention concept" is to give inhaled steroids early in the disease--in children as well as adults--to prevent irreversible lung damage. The START study, involving nearly 7,000 patients in 32 countries, will investigate the effectiveness of early intervention with inhaled steroids in newly-diagnosed asthmatics aged 6-60 years. Results from a 10 year Danish study by Professor Pedersen suggests that in children, early preventive intervention with inhaled steroids leads to improved lung function with no significant adverse effect on the child's growth rate. At present, medical opinion is divided about whether very early use of inhaled steroids is justified, particularly in children. The START study should provide more evidence about the optimum time to begin this treatment.

哮喘:多早开始使用吸入类固醇?
使用吸入类固醇来预防炎症是治疗中度至重度哮喘的标准部分。“早期干预概念”是指在疾病早期(儿童和成人)给予吸入类固醇,以防止不可逆转的肺损伤。START研究涉及32个国家的近7000名患者,将调查吸入类固醇早期干预对6-60岁新诊断的哮喘患者的有效性。Pedersen教授在丹麦进行的一项为期10年的研究结果表明,在儿童中,吸入类固醇的早期预防性干预可以改善肺功能,对儿童的生长速度没有明显的不利影响。目前,医学界对早期使用吸入性类固醇是否合理存在分歧,尤其是在儿童中。START研究应该提供更多关于开始这种治疗的最佳时间的证据。
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