-------------Study Says Use of Oral Drug Better in Treating Severe Asthma Cases
　　
　　By Gene Emery

B O S T O N, Sept. 6  The steroid prednisone, if taken by mouth, is twice as effective as newer inhaled drugs for treating children suffering a sudden, severe asthma attack, researchers said in Thursday’s New England Journal of Medicine.

Researchers at the Hospital for Sick Children in Toronto found that youngsters given prednisone liquid recovered faster from a severe asthma attack than those who inhaled the drug fluticasone, sold under the brand name Flovent by Glaxo Wellcome. Glaxo helped pay for the study.

“In our trial of therapy for children with severe acute asthma, the degree of improvement in pulmonary function in the initial four hours among those treated with prednisone was about twice that in those given fluticasone,"said the team, led by Dr. Suzanne Schuh.

Emergency Room Changes
　　As a result, they said, “We recommend that inhaled fluticasone or similar inhaled corticosteroids not be used in the management of severe asthma in the emergency department."

The findings, the doctors warned, may not apply to youngsters whose asthma is not severe enough to send them to an emergency room.

The prednisone liquid may have worked better, the Schuh team speculated, because it can get to the affected area more effectively. In airways blocked by mucus, they said, the mucus may prevent the fluticasone from being absorbed.

“Since our entire study group consisted of children with severe disease, they may have had too much acute inflammation and mucous plugging to be successfully treated with inhaled corticosteroids,"Schuh and her colleagues said.

The study found that 27 percent of the prednisone recipients had an excellent response to the drug, nearly three times more than the children getting fluticasone. And while none of the prednisone patients had their breathing problems worsen, 25 percent of the fluticasone patients actually had their lung capacity deteriorate during the first four hours after treatment.

Thirty-one percent of the patients getting the inhaled drug had to be hospitalized versus 10 percent of the children who got the prednisone liquid.

　　(From ABCNEWS.com)