Effect of Adding Long-acting β2-agoniststo Inhaled Corticosteroids in Uncontrolled Preschool Asthma: A Retrospective Observational Study at Mahasarakham Hospital
Keywords:
Preschool children, Uncontrolled asthma, ICS plus LABA, Treatment outcomeAbstract
Background and Objectives Asthma in preschool children is a common chronic disease, posing a significant global challenge in disease control. Inhaled corticosteroid (ICS) monotherapy alone is often insufficient for symptom control in children with uncontrolled asthma. Current recommendations suggest adding long-acting β2-agonists (LABA) to ICS to enhance treatment efficacy, though clinical data in preschool children remain limited. This study aimed to evaluate the effects of adding LABA to ICS therapy on asthma control among preschool children with uncontrolled asthma at Mahasarakham Hospital.
Methods This retrospective observational study reviewed medical records of children under five years old who attended the asthma clinic at Mahasarakham Hospital between 2018 and 2020. A total of 120 patients were included and divided equally into two groups: 60 receiving ICS monotherapy and 60 receiving combination therapy with ICS plus LABA. Data were analyzed using descriptive and inferential statistics, including the chi-square test, Fisher’s exact test, and the independent t-test. Statistical significance was set at p < 0.05.
Results Most patients were male (60.83%). The group treated with ICS plus LABA achieved significantly better asthma control compared with the ICS-only group (95.00% vs. 58.33%, p < 0.001). Moreover, the combination therapy group had significantly lower rates of hospital admissions, nocturnal asthma symptoms, emergency room visits, and systemic antibiotic use (p = 0.012).
Conclusion and Recommendation The findings demonstrate that the addition of LABA to ICS therapy significantly improves asthma control, reduces exacerbations, and decreases healthcare utilization among preschool children with uncontrolled asthma, without increasing adverse effects. These results strongly support the standardized use of Combination therapy with ICS and LABA as an effective management option for this population. Future studies should include randomized controlled trials (RCTs) to confirm the long-term efficacy and safety of LABA use in preschool children.
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