In a research conducted by Lemanske and colleagues, it was found that many children linked to inhaled corticosteroid (ICS) can face phases of poor control and step-up controller therapy should be used in such cases.
The research tries to sketch some outlines for clinicians so that they can give appropriate step-up therapy to children suffering from asthma following first-line ICS.
The research also focused on the 3 regimens for step-up controller therapy and examined which can be a better option for children with insufficiently controlled asthma.
In the research, children 6-17 years of age who had mild-to-moderate asthma were observed, keeping in mind the National Heart, Lung, and Blood Institute guidelines.
An 8-week run-in trial was performed and the participants were given 100µg of inhaled fluticasone every day.
If this did not help, 48-week comparative trial was given to them where each child was given 3 regimens for 16 weeks.
While undergoing ICS step-up periods, children were given 250µg of inhaled fluticasone every day.
In the LABA step-up periods, 100 µg of inhaled fluticasone and 50 µg of salmeterol and ultimately on LTRA step-up periods, 100 µg of inhaled fluticasone and 5-10 mg of montelukast per day was given to the participants.
The research was conducted on 480 patients and 182 during the run-in period reported uncontrollable asthma. Out of them, 86% were subjected to full trial and 165 completed at least 2 treatment cycles.
It was conclusively found that 98% of the patients were better on at least 1 of the step-up regimens and the LABA turned out to be better for more patients.