Fluticason zur Asthmatherapie im Kindesalter

Background. Fluticasone proprionate is a recent addition to inhaled corticosteroids available for paediatric use. This review summarises the existing data on efficacy and safety. Doses and application. The licensed dose from 4 years of age is 400 μg per day. There have been no controlled studies regarding the use of higher doses of fluticasone proprionate up to 1000 μg per day in severe persistent childhood asthma. In daily doses up to 400 μg it has been compared favourably with beclomethasone diproprionate and budesonide. While there is a measurable effect on the hypothalamic-pituitary-adrenal axis its clinical relevance is unclear. Most importantly, there is a relative lack of data in the age group under 4 years, where potential side-effects may be most relevant. Application is possible as metered dose inhaler via a spacer device or from a dry powder inhaler which is the preferred mode of application in most patients. As with all other inhaled corticosteroids it is important to ascertain the diagnosis of asthma and that the lowest possible dose of fluticasone is used to achieve asthma control. If higher doses are indicated, growth should be monitored regularly and assessment of the HPA-axis should be considered in individual patients.