NEW YORK (Reuters Health) – Results of a meta-analysis indicate that moderate doses of inhaled corticosteroids do not have any clinically relevant advantage over low doses in children with mild-to-moderate persistent asthma.

The findings, reported in the January issue of Pediatrics, indicate however that the data are insufficient to define the dose-response relationship of inhaled corticosteroids in terms of efficacy and safety in children with persistent asthma.

Dr. Linjie Zhang at the Federal University of Rio Grande in Brazi, and colleagues in Sweden and the USA, note that asthma guidelines recommend a dose of up to 400 mcg/day beclomethasone dipropionate equivalent for children with mild-to-moderate persistent asthma. Still, the authors note, these recommendations are based on results from individual randomized trials, and the dose response relationship of inhaled corticosteroids in childhood asthma has not be well established.

They therefore conducted a systematic review of randomized controlled trials that compared two or more doses of inhaled corticosteroids in children aged 3 to 18 years with persistent asthma. Meta-analyses were performed to compare moderate (300-400 mcg/day beclomethasone equivalent) with low (no more than 200 mcg/day) doses.

Of the 14 trails involving 5768 asthmatic children that were included in the study, six trials contributed to the pooled results comparing clinical and functional benefits between moderate and low doses of inhaled corticosteroids.