Once-daily ciclesonide in children: Efficacy and safety in asthma

ObjectiveTo compare the efficacy and safety of once-daily inhaled ciclesonide 40 μg (CIC40), 80 μg (CIC80), and 160 μg (CIC160) with placebo in children with persistent asthma of all severities.Study designOverall, 1031 children age 4 to 11 years were randomized into 2 identical double-blinded, placebo-controlled, parallel group studies consisting of a run-in phase followed by 12 weeks of treatment. Both studies were designed to allow for a prespecified integrated analysis. The primary outcome variable was change in forced expiratory volume in 1 second (FEV1) percent predicted between baseline and study end; treatment comparisons were assessed using analysis of covariance. Additional endpoints included asthma symptom scores, daily albuterol use, and safety, including hypothalamic–pituitary–adrenal (HPA) axis function.ResultsBaseline characteristics were comparable; 59.4% of patients had moderate asthma, and 24.1% had severe asthma. All ciclesonide doses were associated with greater improvements in baseline to week 12 FEV1 percent predicted versus placebo (CIC40, 11.97; CIC80, 13.58, P <.05; CIC160, 14.17, P < .01). Significant improvements in asthma symptoms (P < .01) and reductions in albuterol use were reported. Ciclesonide was well tolerated with no effect on HPA axis function.ConclusionsIn this integrated analysis, ciclesonide was effective and well tolerated in children with persistent asthma.