This study was designed to evaluate if, in children with asthma, a stepwise treatment (five levels varying from once daily fluticasone propionate 100mcg until twice daily a fixed combination of salmeterol and fluticasone propionate 50/500 mcg) based on symptom scores alone results in a sub-optimal treatment when compared to treatment based on cumulative symptom scores and bronchial hyperresponsiveness (PD20 methacholine).

Inclusion criteria:

• Children with a documented history of asthma.
• Using inhaled steroids from 100 mcg up to 500 mcg twice daily for at least 1 month before study start.
• Must be able to perform reproducible lung function tests.
• Must have a positive RAST or skin prick test.
• During the treatment period, the patient has to be hyperreactive (defined as PD20 methacholine < 150 mcg) and/or have a cumulative symptom score of 14 based on the daily record card filled in during the last 2 weeks of the run-in period.

Exclusion criteria:

• History of an acute upper or lower respiratory tract infection, middle ear, or sinus infection 4 weeks prior to visit 1.
• Admitted to hospital due to a respiratory disease 4 weeks prior to visit 1.
• Received oral corticosteroids within 4 weeks prior to visit 1.
• Existence of any disorder that affects growth.
• Clinical or laboratory evidence of a serious systemic disease, or suspected hypersensitivity to corticosteroids, lactose or short/long acting B2-agonists.