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Long-Acting Βagonists Best Option for Step Up Therapy for Children With Uncontrolled Asthma
Long-Acting Βagonists Best Option for Step Up Therapy for Children With Uncontrolled Asthma
EDITORS NOTE: Journals reviewed for this issue: Archives of Disease in Childhood, Archives of Pediatrics and Adolescent
Medicine, British Medical Journal, Journal of the American Medical Association, The Journal of Pediatrics, The Lancet, New
England Journal of Medicine, Pediatric Infectious Diseases Journal, and Pediatrics. Heidi Marleau, MLS, Ebling Library for the
Health Sciences, University of Wisconsin, contributed to the review and selection of this months abstracts.
John G. Frohna, MD, MPH
References
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Long-acting bagonists best option for stepup therapy for children with uncontrolled
asthma
Lemanske RJ, Mauger D, Sorkness C, Jackson D, Boehmer S,
Martinez F, et al. Step-up therapy for children with uncontrolled asthma receiving inhaled corticosteroids. N Engl J
Med 2010;362:975-85.
Question Among children who have uncontrolled asthma
despite the use of low-dose inhaled corticosteroids (ICS),
what is the best option for step-up therapy?
Design Randomized, blinded, multicenter study.
Setting Childhood Asthma Research and Education (CARE)
Network sites.
Participants One hundred eighty-two children (6 to 17 years
of age) who had uncontrolled asthma while receiving 100 mg
of fluticasone twice daily.
Intervention Each participant received three blinded stepup therapies in random order for 16 weeks: 250 mg of fluticasone twice daily (ICS step-up), 100 mg of fluticasone plus 50
mg of a long-acting b-agonist twice daily (LABA step-up), or
100 mg of fluticasone twice daily plus 5 or 10 mg of a leukotriene-receptor antagonist daily (LTRA step-up).
References