Efficacy and Safety of Nebulised Beclomethasone Dipropionate Plus as Needed Salbutamol vs as Needed Salbutamol or as Needed Salbutamol/Beclomethasone Fixed Combination in Young Children With Asthma Symptoms
Efficacy and Safety of Nebulised Beclomethasone Dipropionate Plus as Needed Salbutamol vs as Needed Salbutamol or as Needed Salbutamol/Beclomethasone Fixed Combination in Young Children With Asthma Symptoms
To demonstrate a superior efficacy of BDP plus rescue salbutamol suspension for nebulisation,
 compared to placebo plus rescue salbutamol, in the relief of symptoms of asthma in young
 children with persistent symptoms of asthma.
Asthma is a chronic disease which is estimated to affect over 25 million people both in the
 US and Europe(i.e. approximately 10% of the total population).There is evidence that over the
 last 20 years prevalence has considerably increased, especially among children. The diagnosis
 of asthma in children may be difficult, largely because episodic wheezing and cough are among
 the common symptoms encountered in childhood illnesses, particularly in children under 3
 years old.Although in these young children there is the possibility of over treatment, the
 episodes of wheezing may be reduced in intensity by the effective use of anti-inflammatory
 medications and bronchodilators rather than antibiotics. At present, pharmacological therapy
 is used to treat reversible airway obstruction, inflammation and hyperreactivity in both
 children and adults. Medications include preventive treatments in forms of
 antinflammatory/antiallergic agents (e.g. glucocorticosteroids, leukotriene antagonists,
 cromolyn sodium) and reliever treatments, in form of bronchodilators (e.g. β-adrenergic
 agonists, anticholinergics). Comparisons: Beclomethasone suspension for nebulisation (400 mcg
 U.D.V.) plus as needed salbutamol compared to placebo plus as needed salbutamol and to as
 needed salbutamol/beclomethasone fixed combination.
Inclusion Criteria:

 Patients will be enrolled into the 2-week placebo run-in period if they meet all the
 following criteria:

 -  Age ≥ 1 year and ≤ 4 years.

 -  At least 3 episodes of wheeze or asthma-like symptoms in the 6 months preceding the
 study entry.

 -  A cooperative attitude and ability to be trained to inhale correctly from the device
 and to complete the diary cards.

 -  Written parental/guardian informed consent obtained.

 Patients will be then randomised to the treatment period if they meet all the previous
 criteria plus:

 -  Presence in at least 7 days out of the 14 days of the run-in period of at least one of
 the following symptoms: wheeze, cough or shortness of breath; or had required at least
 one dose of relief salbutamol.

 Exclusion Criteria:

 -  History of severe asthma exacerbation or exacerbations requiring hospitalisation in
 the previous 4 weeks.

 -  Symptomatic infection of the airways requiring treatment with antibiotics or
 antimycotics in the previous 4 weeks.

 -  Treatment with inhaled steroids in the previous 4 weeks or oral steroids in the
 previous 8 weeks.

 -  Treatment with methyl-xantine derivatives in the previous 4 weeks.

 -  Treatment with long-acting β2-agonists in the previous 2 weeks.

 -  Changes in asthma medications taken on regular basis in the previous 4 weeks.

 -  Symptoms of asthma limited to seasonal allergen exposure.

 -  History of clinically significant cardiac, renal, neurologic, hepatic, endocrine or
 pulmonary disease (except asthma), or laboratory testing abnormalities, whose sequelae
 and/or treatments can interfere with the results of the present study.

 -  Evidence of pulmonary malformations.

 -  Evidence of immunological deficiency (patients to be withdrawn if diagnosed during the
 study).

 -  Cancer or any other chronic disease with prognosis < 2 years.

 -  Hypersensitivity to inhaled corticosteroids.

 -  Participation in another trial in the last 4 weeks.