Treatment of Aerosol BDP for Managing Exacerbations in Chronic Asthmatic Patients, ages 5-18, and those with Corticosteroid Dependence

Pediatric chronic asthma management often requires inhaled corticosteroid use, like beclomethasone dipropionate (BDP). While BDP has been a keystone in asthma treatment for decades, the research assessing its efficacy and safety, particularly in ages 5-18, were conducted between the 1970s to 2005, leaving a significant gap in recent studies. This systematic review evaluates the efficacy of BDP in improving pulmonary function and resolving corticosteroid dependence in chronic asthmatic children, while also assessing its potential side effects.Out of 273 studies, 20 fit the inclusion criteria, encompassing 1495 children, ages 5-18, with chronic asthma and some with corticosteroid dependence. The trials compared the administration of BDP to a placebo, across different timeframes and doses. Pulmonary function metrics (FEV1, PEFR, PEF, and PFR), methacholine tests, and symptom scores, displayed significant improvement in children receiving BDP. Common observed side effects among majority of studies were oropharyngeal candidiasis, rhinitis, and eczema. Though studies display BDP as a beneficial treatment option, advances in asthma treatments and inhaler technology since then have outpaced the available research, making it difficult to assess BDP’s current role in childhood chronic asthma management. Conflicting findings on growth suppression and adrenal dysfunction raise concerns about the reliability and certainty of existing data on BDP. This highlights the need for updated, comprehensive studies to resolve these contradictions and clarify BDP’s role in managing pediatric asthma, in order to update clinical guidelines.