Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med. 2000. PMID 11027739

One-paragraph summary

CAMP randomized 1,041 children aged 5–12 with mild-to-moderate asthma to budesonide, nedocromil or placebo for four to six years. Neither active treatment improved the primary post-bronchodilator FEV1-growth outcome. Budesonide improved airway responsiveness and reduced hospitalizations (2.5 versus 4.4 per 100 person-years), urgent visits (12 versus 22 per 100 person-years), prednisone courses and rescue use versus placebo. Mean height gain was 1.1 cm lower with budesonide, mainly during the first year.

Key findings

• Better control and fewer acute-care events did not translate into the prespecified long-term post-bronchodilator FEV1 trajectory benefit.
• Nedocromil reduced urgent visits and prednisone courses but had less effect than budesonide across control measures.
• The growth signal was small and temporally concentrated rather than progressively widening during the trial.

Limitations

• Reliever and controller practice has changed substantially since trial conduct.
• The trial studied a selected mild-to-moderate pediatric population.
• Group-average growth does not replace individual longitudinal monitoring.

Why it matters

CAMP separates disease control from disease modification. ICS clearly prevents morbidity while not “curing” the underlying trajectory in this trial; this distinction remains central to counseling families and designing prevention studies.

Cited by wiki pages

• asthma in children
• mild and moderate asthma