According to NIH guidelines for management of moderate-persistent asthma in a school-aged child, which daily plan is the BEST INITIAL recommendation?

According to NIH guidelines for management of moderate-persistent asthma in a school-aged child, which daily plan is the BEST INITIAL recommendation?

• A. Low-dose inhaled corticosteroids plus long-acting beta-2-agonist
• B. High-dose inhaled corticosteroids
• C. Leukotriene inhibitor
• D. Methylxanthine and a mast cell inhibitor

Answer: (D)

For moderate persistent asthma in school-aged children, the daily controller plan that provides the best early control combines an inhaled corticosteroid with a long-acting beta-agonist. The corticosteroid tackles the underlying inflammation of the airways, while the LABA improves bronchodilation and helps prevent symptoms and exacerbations more effectively than increasing steroid dose alone. This ICS-LABA approach is favored over simply using high-dose steroids, which adds systemic exposure without the same incremental benefit; over leukotriene inhibitors used alone, which are generally less effective for moderate persistent disease; and over older options like theophylline or mast cell stabilizers, which have more side effects and are less effective.

For moderate persistent asthma in school-aged children, the daily controller plan that provides the best early control combines an inhaled corticosteroid with a long-acting beta-agonist. The corticosteroid tackles the underlying inflammation of the airways, while the LABA improves bronchodilation and helps prevent symptoms and exacerbations more effectively than increasing steroid dose alone. This ICS-LABA approach is favored over simply using high-dose steroids, which adds systemic exposure without the same incremental benefit; over leukotriene inhibitors used alone, which are generally less effective for moderate persistent disease; and over older options like theophylline or mast cell stabilizers, which have more side effects and are less effective.