Inhaled corticosteroids in children with persistent asthma: effects on growth

Zhang, Linjie; Prietsch, Sílvio O. M.; Ducharme, Francine M

doi:10.1002/14651858.cd009471.pub2

Cited by 101 publications

(72 citation statements)

References 84 publications

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“…Systemic adverse effects such as growth suppression and local effects including oropharyngeal candidiasis are well recognised in association with ICS [4][5][6][7]. With recent pragmatic studies showing greater adherence to, and effectiveness of, LTRA compared to ICS [8][9][10], the prospect of increased adherence resulting in better asthma control has renewed interest in the use of LTRA as monotherapy or adjunct therapy.…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric adverse drug reactions in children initiated on montelukast in real-life practice

et al. 2017

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@ERSpublicationsThe incidence of children on montelukast with drug cessation due to neuropsychiatric adverse events was >10% http://ow.ly/nCGG30bgjpd ABSTRACT Although montelukast is generally well tolerated, postmarketing studies have reported serious neuropsychiatric adverse drug reactions (ADRs) leading to a United States Food and Drug Administration black box warning. The objective of this study was to determine the incidence of neuropsychiatric ADRs leading to discontinuation of montelukast in asthmatic children.We conducted a retrospective cohort study in children aged 1-17 years initiated on montelukast. In a nested cohort study, children initiated on montelukast as monotherapy or adjunct therapy to inhaled corticosteroids (ICS) were matched to those initiated on ICS monotherapy. A non-leading parental interview served to ascertain the occurrence of any ADRs with any asthma medication, and circumstances related to, and evolution of, the event.Out of the 106 participants who initiated montelukast, most were male (58%), Caucasian (62%) with a median (interquartile range) age of 5 (3-8) years. The incidence (95% CI) of drug cessation due to neuropsychiatric ADRs was 16 (10-26)%, mostly occurring within 2 weeks. Most frequent ADRs were irritability, aggressiveness and sleep disturbances. The relative risk of neuropsychiatric ADRs associated with montelukast versus ICS was 12 (2-90).In the real-life setting, asthmatic children initiated on montelukast experienced a notable risk of neuropsychiatric ADRs leading to drug cessation, that is significantly higher than that associated with ICS.

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Section: Introductionmentioning

confidence: 99%

Neuropsychiatric adverse drug reactions in children initiated on montelukast in real-life practice

et al. 2017

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“…Because ICS have an onset of action within one to four weeks (28), and most trials demonstrated ICS efficacy within three to six months (13,27), a minimum therapeutic trial of three months is recommended. In this age group, budesonide and fluticasone have been studied the most extensively and have been found to be clinically effective (19,27), with fluticasone showing less effect on growth than beclomethasone dipropionate and budesonide at equivalent doses (29). Because delivery by metered-dose inhaler is preferred, budesonide is not recommended because it is only available for use by nebulization in Canada in children <6 years of age.…”

Section: Diagnosis In a Child Presenting Without Signs Of Airflow Obsmentioning

confidence: 99%

Diagnosis and management of asthma in preschoolers: A Canadian Thoracic Society and Canadian Paediatric Society position paper

Ducharme

Dell

Radhakrishnan³

et al. 2015

Paediatrics &Amp; Child Health

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“…Expansion of the indication for low dose inhaled corticosteroids is very surprising since the evidence is clearly lacking and does not consider the possible side-effects of inhaled corticosteroids, which are likely to outweigh the benefits, in particular for children [33]. Moreover, compliance of patients is likely to be even worse than for other steps of GINA.…”

Section: @Erspublicationsmentioning

confidence: 99%