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September 1960, Vol 100, No. 3 >
Article | September 1960

Prolonged Steroid Therapy in Childhood Asthma FREE

J. P. ANDERSON, M.D.
[+] Author Affiliations

Submitted for publication Dec. 1, 1959.

This study was performed at the Chest and Isolation Hospital, Leicester, England, and received an award in the Sheffield Regional Hospital Board Research Prize Competition, 1959.


Am J Dis Child. 1960;100(3):341-352. doi:10.1001/archpedi.1960.04020040343006.
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Comments

Prednisolone was first used in the Leicester Chest Unit for the treatment of bronchial asthma in autumn, 1955. The drug proved effective in certain previously intractable cases, including several children. Within a year all severe, and many moderate cases, had received prednisolone. A certain number, many children, were found to require maintenance doses to keep them free from asthma.

This paper describes the results of giving, and the difficulties of stopping, such long-term steroid therapy for childhood asthma. The 39 asthmatic children involved were observed during two main phases: an initial period up to the end of September, 1957, when uninterrupted prednisolone was usually given; and a subsequent period up to the end of February, 1959, when determined attempts were made to discontinue the drug.

Material and Methods  Selection was fundamentally retrospective: all the children

  1. were under 15 years of age in September, 1957;

  2. had received daily prednisolone

REFERENCES

1 +
Kennedy, M. C. S., and Thursby-Pelham, D. C.:  Cortisone in Treatment of Children with Chronic Asthma , Brit. M.J. 1:1511-1515, 1956;.
2 +
Savidge, R. S., and Brockbank, W.:  Long-Term Control of Severe Bronchial Asthma with Oral Cortisone , Lancet 2:889-893, 1954;.
3 +
Thursby-Pelham, D. C., and Kennedy, M. C. S.:  Prednisolone Compared with Cortisone in Treatment of Children with Chronic Asthma , Brit. M.J. 1:243-247, 1958;.
4 +
Arnoldsson, H.:  Long-Term ACTH and Corticosteroid Therapy in Bronchial Asthma: A Clinical Evaluation , Acta allergol. 12:( (Suppl. 6) ) 1958;, pp. 190.
5 +
 Steroids in Treatment of Asthma, lead article , Brit. M.J. 1:1166, 1958;.
6 +
 More New Steroids, lead article , Lancet 2: 511, 1958;.
7 +
Criep, L. H.:  Prednisone and Prednisolone in the Treatment of Allergic Diseases , J. Allergy 27:220-230 ( (May) ) 1956;.
8 +
Siegel, S. C.; Birnberg, V., and Kelley, V. C.:  Prednisone in the Treatment of Allergic Disorders in Children: Observations of Plasma 17-Hydroxycorticosteroid Levels , A.M.A. J. Dis. Child. 91: 454-459, 1956;.
9 +
Taub, S. J.; Kaplan, M. A., and Aaronson, A. L.:  Prednisone (Meticorten) in Treatment of Bronchial Asthma: Clinical Study , J. Allergy 27: 514-522, 1956;.
10 +
Levin, S. J., and Adler, P.:  Prednisone in the Treatment of Allergic Diseases in Children , A.M.A. J. Dis. Child. 95:178-184, 1958;.
11 +
Niermann, W. A., and Van Metre, T. E., Jr.:  Efficacy of Medrol in Treatment of Bronchial Asthma in Children , Metabolism 7:473-476, 1958;.
12 +
Kern, R. A.:  The Use and Abuse of Steroid Therapy, Notably in Allergic Disorders , Am. J.M. Sc. 233:430-447, 1957;.
13 +
Siegel, S. C.; Ely, R. S.; Birnberg, V., and Kelley, V. C.:  Adrenal Function in Allergy: Plasma 17-Hydroxycorticosteroid Concentrations in Children with Bronchial Asthma , J. Allergy 27: 504-513 1956;.
14 +
Jenkins, C. M.:  Clinical Study of Prednisone in Severe Intractable Bronchial Asthma , Ann. Allergy 13:700-709, 1955;.
15 +
Nabarro, J. D. N.: Personal communication to the author, 1957.
16 +
Van Metre, T. E., Jr., and Pinkerton, H. L., Jr.:  Growth Suppression in Asthmatic Children Receiving Prolonged Therapy with Prednisone and Methylprednisolone , J. Allergy 30:103-113, 1959;.
17 +
Blodgett, F. M.; Burgin, L.; Iezzoni, D.; Gribetz, D., and Talbot, N. B.:  Effects of Prolonged Cortisone Therapy on Statural Growth, Skeletal Maturation and Metabolic Status of Children , New England J. Med. 254:636-641, 1956;.
18 +
Brockbank, W.; Savidge, R. S., and Brebner, H.:  Long-Term Control of Severe Bronchial Asthma with Oral Cortisone: Second Report , Lancet 2:666-670, 1957;.
19 +
Pearson, R. S. B.:  Therapy in Asthma with Special Reference to Steroids (Report of B.T.A. Annual Conference) Tubercle , London 40:306, 1959;.
20 +
Bonham Carter, R. E.: Asthma in Childhood, address to Leicester Medical Society, February, 1959.
21 +
Baylis, R. I. S.:  Patients on Steroids , Brit. M.J. 1:1536, 1958;.
22 +
Williams, D. A.: Use of Steroids, paper read at Chest and Heart Association Symposium on Bronchial Asthma, February, 1959.
23 +
Levin, S. J.:  The Management of the Acute Attack of Asthma in Childhood , A.M.A. J. Dis. Child. 97:432-438, 1959;.
24 +
Brown, E. B., and Seideman, T.:  The Use of Prednisone and Prednisolone in Treatment of Allergic Diseases , J.A.M.A. 163:713-718, 1957;.
25 +
Sherman, W. B., in A Text-Book of Medicine , Ed. 9, by Cecil and Loeb, Philadelphia, W. B. Saunders Company, 1955;, p. 474.
26 +
Smith, J. M.:  Asthma in School Children , Acta allergol. 9:226-227, 1955;.
27 +
Dees, S. C.:  Development and Course of Asthma in Children , A.M.A. J. Dis Child. 93: 228-233, 1957;.
28 +
Overall, J. C.:  The Symptomatic Treatment of Asthma , A.M.A. J. Dis. Child. 93:246-254, 1957;.
29 +
 Prolonged Steroid Treatment of Asthma, answer in Queries and Minor Notes , J.A.M.A. 163:908 ( (March 9) ) 1957;.
30 +
Siegel, S. C.; Lovin, B. J.; Ely, R. S., and Kelley, V. C.:  Adrenal Function in Allergy: III. Effect of Prolonged Intermittent Steroid Therapy in Allergic Children , Pediatrics 24:434-447, 1959;.

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References

1 +
Kennedy, M. C. S., and Thursby-Pelham, D. C.:  Cortisone in Treatment of Children with Chronic Asthma , Brit. M.J. 1:1511-1515, 1956;.
2 +
Savidge, R. S., and Brockbank, W.:  Long-Term Control of Severe Bronchial Asthma with Oral Cortisone , Lancet 2:889-893, 1954;.
3 +
Thursby-Pelham, D. C., and Kennedy, M. C. S.:  Prednisolone Compared with Cortisone in Treatment of Children with Chronic Asthma , Brit. M.J. 1:243-247, 1958;.
4 +
Arnoldsson, H.:  Long-Term ACTH and Corticosteroid Therapy in Bronchial Asthma: A Clinical Evaluation , Acta allergol. 12:( (Suppl. 6) ) 1958;, pp. 190.
5 +
 Steroids in Treatment of Asthma, lead article , Brit. M.J. 1:1166, 1958;.
6 +
 More New Steroids, lead article , Lancet 2: 511, 1958;.
7 +
Criep, L. H.:  Prednisone and Prednisolone in the Treatment of Allergic Diseases , J. Allergy 27:220-230 ( (May) ) 1956;.
8 +
Siegel, S. C.; Birnberg, V., and Kelley, V. C.:  Prednisone in the Treatment of Allergic Disorders in Children: Observations of Plasma 17-Hydroxycorticosteroid Levels , A.M.A. J. Dis. Child. 91: 454-459, 1956;.
9 +
Taub, S. J.; Kaplan, M. A., and Aaronson, A. L.:  Prednisone (Meticorten) in Treatment of Bronchial Asthma: Clinical Study , J. Allergy 27: 514-522, 1956;.
10 +
Levin, S. J., and Adler, P.:  Prednisone in the Treatment of Allergic Diseases in Children , A.M.A. J. Dis. Child. 95:178-184, 1958;.
11 +
Niermann, W. A., and Van Metre, T. E., Jr.:  Efficacy of Medrol in Treatment of Bronchial Asthma in Children , Metabolism 7:473-476, 1958;.
12 +
Kern, R. A.:  The Use and Abuse of Steroid Therapy, Notably in Allergic Disorders , Am. J.M. Sc. 233:430-447, 1957;.
13 +
Siegel, S. C.; Ely, R. S.; Birnberg, V., and Kelley, V. C.:  Adrenal Function in Allergy: Plasma 17-Hydroxycorticosteroid Concentrations in Children with Bronchial Asthma , J. Allergy 27: 504-513 1956;.
14 +
Jenkins, C. M.:  Clinical Study of Prednisone in Severe Intractable Bronchial Asthma , Ann. Allergy 13:700-709, 1955;.
15 +
Nabarro, J. D. N.: Personal communication to the author, 1957.
16 +
Van Metre, T. E., Jr., and Pinkerton, H. L., Jr.:  Growth Suppression in Asthmatic Children Receiving Prolonged Therapy with Prednisone and Methylprednisolone , J. Allergy 30:103-113, 1959;.
17 +
Blodgett, F. M.; Burgin, L.; Iezzoni, D.; Gribetz, D., and Talbot, N. B.:  Effects of Prolonged Cortisone Therapy on Statural Growth, Skeletal Maturation and Metabolic Status of Children , New England J. Med. 254:636-641, 1956;.
18 +
Brockbank, W.; Savidge, R. S., and Brebner, H.:  Long-Term Control of Severe Bronchial Asthma with Oral Cortisone: Second Report , Lancet 2:666-670, 1957;.
19 +
Pearson, R. S. B.:  Therapy in Asthma with Special Reference to Steroids (Report of B.T.A. Annual Conference) Tubercle , London 40:306, 1959;.
20 +
Bonham Carter, R. E.: Asthma in Childhood, address to Leicester Medical Society, February, 1959.
21 +
Baylis, R. I. S.:  Patients on Steroids , Brit. M.J. 1:1536, 1958;.
22 +
Williams, D. A.: Use of Steroids, paper read at Chest and Heart Association Symposium on Bronchial Asthma, February, 1959.
23 +
Levin, S. J.:  The Management of the Acute Attack of Asthma in Childhood , A.M.A. J. Dis. Child. 97:432-438, 1959;.
24 +
Brown, E. B., and Seideman, T.:  The Use of Prednisone and Prednisolone in Treatment of Allergic Diseases , J.A.M.A. 163:713-718, 1957;.
25 +
Sherman, W. B., in A Text-Book of Medicine , Ed. 9, by Cecil and Loeb, Philadelphia, W. B. Saunders Company, 1955;, p. 474.
26 +
Smith, J. M.:  Asthma in School Children , Acta allergol. 9:226-227, 1955;.
27 +
Dees, S. C.:  Development and Course of Asthma in Children , A.M.A. J. Dis Child. 93: 228-233, 1957;.
28 +
Overall, J. C.:  The Symptomatic Treatment of Asthma , A.M.A. J. Dis. Child. 93:246-254, 1957;.
29 +
 Prolonged Steroid Treatment of Asthma, answer in Queries and Minor Notes , J.A.M.A. 163:908 ( (March 9) ) 1957;.
30 +
Siegel, S. C.; Lovin, B. J.; Ely, R. S., and Kelley, V. C.:  Adrenal Function in Allergy: III. Effect of Prolonged Intermittent Steroid Therapy in Allergic Children , Pediatrics 24:434-447, 1959;.

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