Asthma: how early to start using inhaled steroids?

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.