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Prednisolone reduces recurrent wheezing after first rhinovirus wheeze: a 7‐year follow‐up

Prednisolone reduces recurrent wheezing after first rhinovirus wheeze: a 7‐year follow‐up Background To better understand the role of human rhinovirus‐associated wheeze as a risk factor for childhood recurrent wheezing, a cohort of young children experiencing their first wheezing episode was followed until school age. Methods All 111 hospitalized wheezing children (median age, 12 months) were initially participated in a randomized, double‐blind, placebo‐controlled, parallel trial on the efficacy of oral prednisolone. In this 7‐yr follow‐up, risk factors for recurrent wheezing were analysed, and then, the efficacy of prednisolone was evaluated overall and in pre‐specified subgroups post‐hoc. The main outcome was time to recurrent wheezing. Results The strongest independent risk factor for recurrent wheezing was rhinovirus detection (hazard ratio 3.54; 95% confidence interval 1.51–8.30) followed by sensitization (3.47; 1.55–8.30, respectively) age <1 yr (2.45; 1.29–4.65) and eczema (2.33; 1.11–4.90). Overall, prednisolone did not prevent recurrent wheezing. In subgroup analysis, prednisolone was associated with less recurrent wheezing in children affected by rhinovirus (0.32; 0.12–0.90, adjusted to sensitization, young age, viral aetiology and parental asthma) and/or with eczema (0.27; 0.08–0.87, adjusted respectively). Conclusions Our data strengthen the role of rhinovirus‐associated wheeze as an important risk factor for recurrent wheezing and asthma in young first‐time wheezing children. Prospective randomized trials on the efficacy of corticosteroids in rhinovirus‐associated early wheezing are warranted. (ClinicalTrials.gov number, NCT 00494624) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Allergy and Immunology Wiley

Prednisolone reduces recurrent wheezing after first rhinovirus wheeze: a 7‐year follow‐up

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References (57)

Publisher
Wiley
Copyright
Copyright © 2013 John Wiley & Sons A/S
ISSN
0905-6157
eISSN
1399-3038
DOI
10.1111/pai.12046
pmid
23373881
Publisher site
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Abstract

Background To better understand the role of human rhinovirus‐associated wheeze as a risk factor for childhood recurrent wheezing, a cohort of young children experiencing their first wheezing episode was followed until school age. Methods All 111 hospitalized wheezing children (median age, 12 months) were initially participated in a randomized, double‐blind, placebo‐controlled, parallel trial on the efficacy of oral prednisolone. In this 7‐yr follow‐up, risk factors for recurrent wheezing were analysed, and then, the efficacy of prednisolone was evaluated overall and in pre‐specified subgroups post‐hoc. The main outcome was time to recurrent wheezing. Results The strongest independent risk factor for recurrent wheezing was rhinovirus detection (hazard ratio 3.54; 95% confidence interval 1.51–8.30) followed by sensitization (3.47; 1.55–8.30, respectively) age <1 yr (2.45; 1.29–4.65) and eczema (2.33; 1.11–4.90). Overall, prednisolone did not prevent recurrent wheezing. In subgroup analysis, prednisolone was associated with less recurrent wheezing in children affected by rhinovirus (0.32; 0.12–0.90, adjusted to sensitization, young age, viral aetiology and parental asthma) and/or with eczema (0.27; 0.08–0.87, adjusted respectively). Conclusions Our data strengthen the role of rhinovirus‐associated wheeze as an important risk factor for recurrent wheezing and asthma in young first‐time wheezing children. Prospective randomized trials on the efficacy of corticosteroids in rhinovirus‐associated early wheezing are warranted. (ClinicalTrials.gov number, NCT 00494624)

Journal

Pediatric Allergy and Immunology – Wiley

Published: May 1, 2013

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