Growth in asthmatic children treated with fluticasone propionate

Allen, David B.; Bronsky, Edwin A.; LaForce, Craig; Nathan, Robert A.; Tinkelman, David G.; Vandewalker, Mark; König, Peter

doi:10.1016/s0022-3476(98)70023-x

Cited by 161 publications

(94 citation statements)

References 19 publications

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“…yr -1 slower than children from the cromolyn group, the difference was not statistically significant [51]. Another study comparing growth in asthmatic children treated for 1 yr with placebo and FP (100 and 200 mg daily) reported no significant overall difference in growth rates between groups [52]. However, when the difference in growth rates between each of the two FP groups separately compared to placebo were analysed, the group using the higher dose (200 mg daily) showed significantly reduced growth of 0.42 cm .…”

Section: Medium-term Studies (Months)mentioning

confidence: 96%

Inhaled corticosteroids reduce growth. Or do they?

Brand

2001

Eur Respir J

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The class label warning in the United States for inhaled corticosteroids (ICS's) states that these drugs may reduce growth velocity in children. In this paper, the evidence for this warning is reviewed from a clinical point of view.Children with asthma tend to grow slower than their healthy peers during the prepubertal years because they go into puberty at a later age. However, asthmatic children do achieve a (near) normal adult height. In randomized controlled clinical trials, the use of inhaled beclomethasone, budesonide and fluticasone is associated with a reduced growth during the first months of therapy, in the order of magnitude of approximately 0.5–1.5 cm·yr−1. It is, however, unlikely that such an effect continues or persists because accumulating evidence shows that asthmatic children, even when they have been treated with ICS for years, attain normal adult height. Individual rare cases have been reported, however, where ICS use was associated with clinically relevant growth suppression.Inhaled corticosteroids are the most effective therapy available for maintenance treatment of childhood asthma. Fear of reduced growth velocity is based on exceptional cases and not on group data. It should, therefore, not be a reason to withhold or withdraw such highly effective treatment in children with asthma.

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Section: Medium-term Studies (Months)mentioning

confidence: 96%

Inhaled corticosteroids reduce growth. Or do they?

Brand

2001

Eur Respir J

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“…13 Long-term follow-up trials of 100 mcg/day fluticasone dry powder inhaler (DPI) and mometasone DPI in prepubertal children did not show any significant reduction in growth compared with placebo. [14][15][16] In conclusion, the evidence clearly supports that the ICSs are the preferred long-term controller medications for all levels of persistent asthma due to their consistent efficacy. 17 As emerging evidence for the rescue approach in patients who are well controlled is compelling, current data provide the opportunity for future trials to investigate better stepdown strategies with different ICSs and delivery devices for the management of asthma.…”

mentioning

confidence: 76%

As Needed Use of Inhaled Corticosteroids for Management of Mild Persistent Asthma in Children

Raissy¹,

Blake²

2011

Pediatric Allergy, Immunology, and Pulmonology

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“…Each study was randomized and used stadiometry to measure patient height (table 1). Two were of 12 months duration [10,11], whereas the third was performed over 27 months [12].…”

Section: Type 1 Growth Studies (Control: Placebo)mentioning

confidence: 99%

“…Only one study analysed patients who were prepubertal [11]. The inclusion of pubertal patients in the studies of JONASSON et al [12] and SIMONS et al [10] is likely to have increased the variability of growth data and more importantly could have confounded the results if the distribution of pubertal patients between treatment groups had been unequal.…”

Section: Type 1 Growth Studies (Control: Placebo)mentioning

confidence: 99%

Evaluating the effects of asthma therapy on childhood growth: what can be learnt from the published literature?

Price

Hindmarsh²,

Hughes³

et al. 2002

Eur Respir J

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Evaluating the effects of asthma therapy on childhood growth: what can be learnt from the published literature? J. Price, P. Hindmarsh, S. Hughes, J. Efthimiou. #ERS Journals Ltd 2002. ABSTRACT: The difficulties of assessing the effects of asthma therapy on childhood growth were explored in the first part of this review. In this part of the review growth studies with inhaled corticosteroids were selected that included a control group, measured height by stadiometry and were of o1 yr duration. The studies were classified as type 1 (placebo control), type 2 (nonsteroidal therapy control), type 3 (comparator inhaled corticosteroid control) or type 4 ("real-life" studies with dose adjustment). The design attributes of these studies were then compared with the recommendations described in the first part of this review. Of the 18 studies identified, 17 were susceptible to one or more important confounding factors. Nevertheless, the outcomes of all 18 studies were mostly consistent.At recommended doses, beclomethasone dipropionate and budesonide demonstrated a small degree of growth suppression over 1-2 yrs (study types 1 and 2), but there was little evidence of such an effect with fluticasone propionate. Studies comparing different inhaled corticosteroids at recommended doses indicated more rapid growth with fluticasone propionate than with beclomethasone dipropionate or budesonide. However, none of the inhaled corticosteroids appeared to affect final height.In conclusion, the results from the majority of published growth studies with inhaled corticosteroids must be interpreted with a degree of caution owing to their potential susceptibility to important confounding factors. Further well-designed studies are needed to establish whether different inhaled corticosteroids have different effects on growth in the long term.

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Growth in asthmatic children treated with fluticasone propionate

Cited by 161 publications

References 19 publications

Inhaled corticosteroids reduce growth. Or do they?

Inhaled corticosteroids reduce growth. Or do they?

As Needed Use of Inhaled Corticosteroids for Management of Mild Persistent Asthma in Children

Evaluating the effects of asthma therapy on childhood growth: what can be learnt from the published literature?

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