LONDON, September 10 /PRNewswire/ --

- New Research Suggests Steroid Dosing Should be Checked

Drug experts have warned parents and healthcare professionals to
double-check if children with allergic conditions such as asthma and hayfever
are being over-prescribed corticosteroids. The warning follows research
unveiled at the British Pharmaceutical Conference (BPC) in Manchester
revealing that many children with multiple allergic conditions such as
asthma, eczema and hayfever may be exposed to high, cumulative doses of
corticosteroids through co-prescribing of steroid preparations for different
conditions.

Asthma and hayfever are common conditions in children for which long-term
inhaled or nasal corticosteroids may be prescribed. Some children with severe
conditions may receive both, resulting in high doses of steroids and
increased risk of adverse effects.(1)

An audit of 304 general practices carried out by researchers from
Aberdeen University, including the records of 345,221 children, found that
almost 9% of all children issued with a repeat prescription for an inhaled
corticosteroid for asthma were also prescribed at least one other steroid
preparation such as nasal corticosteroids.

Lead researcher Dr James McLay, Senior Lecturer in the Department of
Medicine and Therapeutics at Aberdeen University, said: "This research shows
that a significant number of children are prescribed more than one
corticosteroid preparation for an allergic condition.

"If a child is prescribed corticosteroid treatment for one condition at
the maximum or near the maximum dose, then another steroid prescription would
tip them into over-exposure."

Dr McLay suggested that GPs may not always recognise that a child is
potentially over-exposed to corticosteroids because general practice systems
may not be set up to alert them to the impact of cumulative corticosteroid
dosing, particularly if prescriptions are issued on a repeat basis. He said:
"While this study did not set out to identify individual children receiving
too high doses of steroids, our data suggests that up to 50% of children
prescribed an inhaled and nasal corticosteroid, together, could be receiving
too high a cumulative dose of steroid.

"We therefore recommend that all healthcare professionals or parents
under the direction of a healthcare professional check for this issue," added
Dr McLay.

The potential long-term toxicity of chronic corticosteroid use in
children is unclear, but there have been concerns about the impact on child
growth. However, most children with asthma eventually attain normal height,
even after receiving moderate corticosteroid doses.(2), (3)

Dr McLay said: "Corticosteroids have revolutionised the treatment of
asthma and probably saved many children's lives. But against a background of
concern about the impact of long-term corticosteroid use, this study suggests
that GPs should always consider the potential cumulative steroid burden for
an atopic child."

The British Pharmaceutical Conference Press Office (September 10, 11 and
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Notes to Editors

The British Pharmaceutical Conference - entitled "The medicines maze:
balancing risks and benefits" - takes place from 10th to 12th September,
2007, at Manchester Central (formerly Manchester International Convention
Centre). The theme of BPC 2007 is reflected throughout the programme, with
keynote speeches and workshops addressing crucial technical and professional
issues that are facing pharmacy today. The conference will showcase the
latest developments in pharmaceutical science and practice research and
include discussion and debate led by expert speakers.

References

(1). Ekins-Daukes S, et al. Burden of corticosteroids in children with
asthma in primary care: retrospective observational study. BMJ 2002;324:1374.

(2). Patel L, et al. Symptomatic adrenal insufficiency during inhaled
corticosteroid treatment. Arch Dis Child 2001;85:330-334.

(3). Agertoft L, Pedersen S. Effect of long-term treatment with inhaled
budesonide on adult height in children with asthma. NEJM 2000;343:1064-1069.