Effectiveness of correction of hypovitaminosis D against the background of standard step therapy of bronchial asthma in children

Introduction . The close interest of a wide range of pediatricians in the problems of bronchial asthma (BA) is due to its prevalence, difficulties in selecting basic therapy, and the high frequency of hypovitaminosis D. Aim . To analyze the frequency of vitamin D deficiency and the effectiveness of its correction by including cholecalciferol preparations in the standard step therapy regimen for bronchial asthma in children. Materials and methods . The study involved 75 children and adolescents from the Stavropol Territory suffering from BA, aged 12.4 [9.5; 14.8] years. From 2018 to 2021, a two-stage study of vitamin D status was conducted in patients – initially and after completion of a 3-month intake of cholecalciferol aqueous solution (CCF). Results . At the 1st stage of treatment, all 3 (100%) patients were over 12 years old and received low doses of ICS each time they used SABA without constant basic therapy. At the 2nd stage of therapy, all 9 (100%) patients used LRA drugs in age-appropriate dosages. At the 3rd stage, 1 (5.3%) child received treatment with medium doses of ICS, 10 (52.6%) children used a fixed combination of ICS-LABA, and 8 (42.1%) a combination of ICS + LRA. The vitamin D status after taking cholecalciferol preparations increased from 18.3 ng/ml to 35.4 ng/ml. Vitamin D deficiency was initially detected in 44 (58.7%) children, and after the correction course – only in 3 (4.0%) people (p < 0.001). Initially, the median AST was 16.0 [12.0; 20.5] points, and at the end of the study 20.0 [16.0; 24.0] points (p < 0.004). Conclusion . Step therapy for asthma should be prescribed in according to current clinical guidelines. ICS should be used more widely as initial basic therapy for asthma, reducing the number of people receiving monotherapy with ALR.