Robert F Lemanske, David T Mauger, Christine A Sorkness, Daniel J Jackson, Susan J Boehmer, Fernando D Martinez, Robert C Strunk, Stanley J Szefler, Robert S Zeiger, Leonard B Bacharier, Ronina A Covar, Theresa W Guilbert, Gary Larsen, Wayne J Morgan, Mark H Moss, Joseph D Spahn, Lynn M Taussig
BACKGROUND: For children who have uncontrolled asthma despite the use of low-dose inhaled corticosteroids (ICS), evidence to guide step-up therapy is lacking. METHODS: We randomly assigned 182 children (6 to 17 years of age), who had uncontrolled asthma while receiving 100 microg of fluticasone twice daily, to receive each of three blinded step-up therapies in random order for 16 weeks: 250 microg of fluticasone twice daily (ICS step-up), 100 microg of fluticasone plus 50 microg of a long-acting beta-agonist twice daily (LABA step-up), or 100 microg of fluticasone twice daily plus 5 or 10 mg of a leukotriene-receptor antagonist daily (LTRA step-up)...
March 18, 2010: New England Journal of Medicine