Corticosteroids' safety affirmed in treatment of childhood asthma

Children being treated with a short course of oral corticosteroids for an acute asthma attack may experience a brief and transient depression of their immune response, according to a recent study conducted by Université de Montréal.

A few rare reports link severe chickenpox infections with oral corticosteroid use.  This prompted researchers to study the immune response in children 3 to 17 years of age who were treated in the emergency department (ED) for an asthma attack. Patients were given antigens and a comparison was made of the immune response between those who did and those who did not receive oral corticosteroids. 

"Several corticosteroid-treated children had a lower immune response, as measured by the amount of antibody produced, than nontreated kids," said Francine M. Ducharme, a Université de Montréal professor and pediatrician and researcher at the Sainte-Justine University Hospital Research Center.

Five weeks after their initial ED visit, the children were revaccinated with the antigen.  Children who received oral corticosteroids showed a comparable immune response to those children who did not receive the medication.

The researchers conclude that in light of the high frequency of oral corticosteroid use over the past 20 years, the very rare occurrence of severe infectious disease is reassuring and suggests that the window of risk is very small and applies only to exposure to a new antigen.  Nevertheless, they recommend that physicians inquire about recent chickenpox exposure in children who did not have the disease or the vaccine. Children with asthma who have not had chickenpox should be appropriately vaccinated.

The study, "A short burst of oral corticosteroid for children with acute asthma: Is there an impact on immunity," was published in Pediatric Allergy, Immunology, and Pulmonology.