{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:34:56Z","timestamp":1761057296094},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2008,9,5]],"date-time":"2008-09-05T00:00:00Z","timestamp":1220572800000},"content-version":"vor","delay-in-days":2865,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2000,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Recurrent wheezing illness in childhood is a frequent reason for consultation in both primary and secondary care and whilst there is widespread support for the earlier introduction of inhaled corticosteroids(ICS) concerns remain about potential adverse systemic effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to identify the feasibility and size of study required to assess the benefits, adverse effects and cost\u2010effectiveness of early introduction of ICS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We entered 86 children (mean age 4.5\u2003years) with at least two consecutive wheezing episodes into a pragmatic randomized controlled trial. All children were already being prescribed \u03b2<jats:sub>2<\/jats:sub>\u2010agonist and those allocated to ICS were prescribed twice daily beclomethasone dipropionate 200 \u03bcg or budesonide 200 \u03bcg. At entry and 3 and 6\u2003months age appropriate lung function (FEV<jats:sub>1<\/jats:sub>, T<jats:sub>ptef<\/jats:sub>:T<jats:sub>e<\/jats:sub>), respiratory symptoms, quality of life of children and carers, growth and sexual maturation, bone mass and bone turnover, and health care costs were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Drop out rate was 8% (7 of 86). No significant differences were found in FEV<jats:sub>1<\/jats:sub> or T<jats:sub>ptef<\/jats:sub>:T<jats:sub>e<\/jats:sub> at 6\u2003months. Respiratory symptoms and health\u2010related quality of life of children and carers improved equally in both groups. No significant differences were found in growth rates or in bone mass. In the ICS group markers of bone turnover (Pyd:Cr) fell (271 vs 237\u2003nmol\/mmol) in contrast to a rise in those on \u03b2<jats:sub>2<\/jats:sub> alone (255 vs 319\u2003nmol\/mmol) <jats:italic>P\u2003<\/jats:italic>&lt;\u20030.05. Combined health care costs were higher in the ICS group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The low drop out rate provided evidence that the protocol was practical and acceptable. In order to confirm these results, and using the same study design, power estimates indicated that 260 children would need to be randomized.<\/jats:p><\/jats:sec>","DOI":"10.1046\/j.1365-2222.2000.00941.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T09:41:06Z","timestamp":1047375666000},"page":"1619-1626","source":"Crossref","is-referenced-by-count":4,"title":["Early introduction of inhaled steroids in wheezing children presenting in primary care. A pilot study"],"prefix":"10.1111","volume":"30","author":[{"given":"A. D. G.","family":"Baxter\u2010Jones","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. J.","family":"Helms","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,9,5]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.52.suppl_1.S1"},{"key":"e_1_2_7_3_2","unstructured":"Guidelines for the Diagnosis and Management of Asthma National Institute of Health Bethesda.1997. Publication no.97\u20134051."},{"key":"e_1_2_7_4_2","unstructured":"Global strategy for asthma management and prevention. National Institute of Health Bethesda.1995. 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