Prednisolone reduces recurrent wheezing after first rhinovirus wheeze: a 7-year follow-up
Article first published online: 3 FEB 2013
© 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd
Pediatric Allergy and Immunology
Volume 24, Issue 3, pages 237–243, May 2013
How to Cite
Prednisolone reduces recurrent wheezing after first rhinovirus wheeze: a 7-year follow-up. Pediatr Allergy Immunol 2013: 00., , , , , .
- Issue published online: 16 APR 2013
- Article first published online: 3 FEB 2013
- Manuscript Accepted: 3 JAN 2013
- Academy of Finland . Grant Numbers: 114034, 132595
- Allergy Research Foundation
- Finnish Medical Foundation
- Foundation for Paediatric Research
- TYKS Foundation
- Research Funds from Specified Government Transfers
- Maud Kuistila Memorial Foundation
- Tampere Tuberculosis Foundation
- Paulo Foundation
- Ida Montin Foundation
To better understand the role of human rhinovirus-associated wheeze as a risk factor for childhood recurrent wheezing, a cohort of young children experiencing their first wheezing episode was followed until school age.
All 111 hospitalized wheezing children (median age, 12 months) were initially participated in a randomized, double-blind, placebo-controlled, parallel trial on the efficacy of oral prednisolone. In this 7-yr follow-up, risk factors for recurrent wheezing were analysed, and then, the efficacy of prednisolone was evaluated overall and in pre-specified subgroups post-hoc. The main outcome was time to recurrent wheezing.
The strongest independent risk factor for recurrent wheezing was rhinovirus detection (hazard ratio 3.54; 95% confidence interval 1.51–8.30) followed by sensitization (3.47; 1.55–8.30, respectively) age <1 yr (2.45; 1.29–4.65) and eczema (2.33; 1.11–4.90). Overall, prednisolone did not prevent recurrent wheezing. In subgroup analysis, prednisolone was associated with less recurrent wheezing in children affected by rhinovirus (0.32; 0.12–0.90, adjusted to sensitization, young age, viral aetiology and parental asthma) and/or with eczema (0.27; 0.08–0.87, adjusted respectively).
Our data strengthen the role of rhinovirus-associated wheeze as an important risk factor for recurrent wheezing and asthma in young first-time wheezing children. Prospective randomized trials on the efficacy of corticosteroids in rhinovirus-associated early wheezing are warranted. (ClinicalTrials.gov number, NCT 00494624)