ONE-YEAR TREATMENT WITH SALMETEROL COMPARED WITH BECLOMETHASONE IN CHILDREN WITH ASTHMA

The aim of this study was to compare the effects of salmeterol and bec lomethasone on lung function and symptoms in children with mild to mod erate asthma. Sixty-seven children not treated with inhaled corticoste roids were randomized in a double-blind parallel study either to salme terol 50 mu g b.i.d. or beclomethasone 200 mu g b.i.d. After one year, FEV1 significantly increased in the beclomethasone group, whereas in the salmeterol group there was a small reduction. Differences between groups were 14.2% predicted (p < 0.0001) and 7.0% predicted (p = 0.007 ) for pre-and postbronchodilator FEV1 values, respectively. PD20 metha choline decreased by 0.73 DD (p = 0.05) in the salmeterol group and in creased by 2.02 DD (p < 0.0001) in the beclomethasone group. Morning a nd evening PEF and symptom scores improved in both groups, although mo re in the beclomethasone group. Asthma exacerbations, for which predni solone was needed, were more frequent in the salmeterol group (17 vers us two), as were the number of withdrawals due to exacerbations (six v ersus one). However, growth was significantly slower in the beclometha sone group (-0.28 SDS) compared with that in the salmeterol group (-0. 03 SDS) (p = 0.001). We conclude that treatment with a moderate dose o f beclomethasone is superior to salmeterol in children with mild to mo derate asthma and recommend that salmeterol should not be used as mono therapy.