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Step-up therapy for uncontrolled asthma in children


Results of the BADGER (Best Add-on Therapy Giving Effective Responses) trial, a triple-crossover randomized study, showed that children with asthma who continued to have symptoms despite being on a low-dose inhaled corticosteroid (ICS) benefited from either an increase in the dose of their ICS, the addition of a long-acting beta-agonist (LABA), or the addition of a leukotriene-receptor antagonist (LTRA); the best overall response was seen with LABA step-up therapy.


Lemanske RF et al. Step-up therapy for children with uncontrolled asthma receiving inhaled corticosteroids. N Engl J Med. 2010;362:975–85.

von Mutius E, Drazen JM. Choosing asthma step-up care [editorial]. N Engl J Med. 2010;362:1042–3.

U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma [PDF].