Initial management in children aged 5 to 11

This content is from the BTS, NICE and SIGN guideline - Asthma: diagnosis, monitoring and chronic asthma management (SIGN 245), 2024.

See also algorithm D for a summary of the pharmacological management of asthma in children aged 5 to 11.

 

R

1.8.1 Offer a twice-daily paediatric low-dose inhaled corticosteroid (ICS), with a short-acting beta2 agonist (SABA) as needed, as initial treatment for children aged 5 to 11 years with newly diagnosed asthma.

[BTS/NICE/SIGN 2024]

 

            

Rationale and impact

Why the committee made the recommendation

Evidence for children aged 5 to 11 showed that regular paediatric low-dose ICS plus SABA as needed was superior to SABA alone, particularly in reducing exacerbations. Using regular ICS did not cause more side effects and was not associated with greater adrenal suppression. There was no evidence for ICS/formoterol combination inhalers used as needed in this age group. The committee therefore recommended regular paediatric low-dose ICS as the preferred treatment option for children aged 5 to 11. However, in view of the evidence supporting the use of ICS/LABA as needed combination inhalers in adults, they made a research recommendation to test the benefits of this combination in children.

How the recommendation might affect practice

The recommendation for treatment of newly diagnosed asthma in children is in line with current practice.

 

Full details of the evidence and the committee’s discussion are in evidence review P: drug classes for initial asthma management.