The prevalence and severity of asthma, one of the common chronic childhood illnesses is on the rise. Its prevalence has substantially increased worldwide, particularly in pre-school children.
It is a costly disease to treat and imposes severe economic burden on the society. The very fact that millions of children worldwide have asthma lays stress upon consideration of the cost-effectiveness of therapies. There have been many studies for asthma treatment in adults or combined analysis of adults and adolescents. There is paucity in the number of analyses done exclusively for children.
A recent study compared the cost-effectiveness of 2 commonly used asthma controllers, fluticasone and montelukast. Data from the Pediatric Asthma Controller Trial were used. Fluticasone
belongs to a class of medications called corticosteroids. Oral inhalation of the drug is widely prescribed in the management of pediatric asthma. It reduces the inflammation that is responsible for narrowing of airways in asthma. Montelukast
works at the receptor level. It modifies the action of leukotrienes, the most potent agents responsible for constricting airways.
Asthma is classified based on the frequency and the timing of asthmatic attacks that the child gets. The result of the multicentric clinical trial performed in children with mild-to-moderate persistent asthma was published in the Journal of Allergy and Clinical Immunology. For children with mild-to-moderate persistent asthma, low-dose fluticasone had lower cost and higher effectiveness compared with montelukast, especially in those with more airway inflammation.
Fluticasone treatment cost less and was also found to be more effective than montelukast. The lower cost and higher effectiveness were more notable in children with more airway inflammation. Fluticasone also gave more asthma-control days during the 48-week study period.
The result of the study is of great value, especially to the developing economies which face a huge monetary loss of productivity from missed school or work. The revelation supports the current guidelines that recommend inhaled corticosteroid therapy as the preferred asthma controller option for mild-to-moderate persistent asthma in children.
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