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PEDIATRICS Vol. 102 No. 1 Supplement July 1998, pp. 265-266

COMMENTARY:
Aerosol Beclomethasone Dipropionate Compared With Theophylline as Primary Treatment of Chronic, Mild to Moderately Severe Asthma in Children, by David G. Tinkelman, MD, et al, Pediatrics, 1993;92:64-77

Received Mar 19, 1998; accepted Mar 19, 1998.

Comments by Clifton T. Furukawa

From the Department of Pediatrics, University of Washington, the Division of Allergy, Children's Hospital and Medical Center, and Northwest Asthma and Allergy Center, Seattle, Washington.

Objective.  To compare the benefits and adverse reactions of theophylline and beclomethasone (BDP) in the long-term control of mild to moderate chronic asthma in children.

Design.  Multicentered, double-blind, double-placebo, randomized, controlled trial.

Patients.  One hundred ninety-five children between the ages of 6 and 16 years with mild to moderate asthma.

Intervention.  Treatment with either BDP, 84 µg four times a day, or sustained-release theophylline administered twice daily I doses adjusted for optimum control of symptoms.

Main Outcome Measures.  Daily diary record of symptoms, peak flow rates, supplemental bronchodilator and glucocorticoid treatment, doctor and hospital visits, absence from work and school, and side effects.

Results.  Aerosol BDP and sustained-release theophylline were effective primary treatments for mild to moderate chronic asthma. BDP resulted in comparable symptom control with less bronchodilator use and fewer courses of systemic steroids than did theophylline. Side effects were observed significantly more frequently with theophylline than with BDP. Growth velocity suppression was noted with BDP and was more pronounced in boys. Suppression was not associated with alterations in cortisol measurements either at baseline or following stimulation.

Conclusions.  Both theophylline and BDP are effective therapy for mild to moderate asthma. Caution must be used with the administration of BDP in children because of possible growth velocity suppression.


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