Steroids to treat asthmatic children: How safe are they?

WASHINGTON - A new University of Montreal study is evaluating the impact of steroid use on the immune system of kids.

The study has suggested that kids experiencing an asthma attack who are treated with a short burst of oral steroids may have a transient depression of immune response.

These findings have implications for asthmatic children who have flare-ups and who may be exposed to new contagious diseases.

“There is no question that the administration of corticosteroids reduces the risk and duration of hospital admission in children with acute asthma remain the most effective treatment for moderate and severe asthma exacerbations,” said first author Francine M. Ducharme of the University of Montreal.

“However, the safety profile of these medications continues to raise concerns among parents and physicians. New concerns over their possible impact on the immune system stem from rare reports linking or severe chickenpox infections linked with corticosteroid administration,” said Ducharme.

Ducharme and colleagues evaluated the immune response of children aged 3 to 17 years, who had arrived at the emergency department (ED) with an asthma attack.

“Several corticosteroid-treated children had a significantly lower immune response, as measured by the amount of antibody produced, than non-treated kids,” said Ducharme.

Children enrolled in the study were revaccinated with the antigen five weeks following their initial ED visit. Comparable immune responses were measured in children exposed to oral corticosteroids and not exposed to corticosteroids.

“These findings indicate there is a transient, not sustained, immune suppression in some children exposed to a new antigen at the same time as a corticosteroid administration.

“In summary, our finding suggest a transient immune suppression occurs in some children who are concomitantly exposed to a new antigen and corticosteroids during an asthma attack, with a recovery within six weeks,” said Ducharme.

“Given the high frequency of use of these drugs over the past 20 years, the very rare occurrence of severe infectious disease is reassuring and would suggest that the window of risk is very small and only applies to exposure to a new antigen. However, before prescribing oral corticosteroids, it would appear prudent to systematically enquire about recent exposure to chickenpox in children who did not have chickenpox or the vaccine,” added Ducharme.

The findings have been published in the journal Pediatric Allergy, Immunology and Pulmonology.(ANI)