Long-, intermediate- and short-term growth studies in asthmatic children treated with inhaled glucocorticosteroids

Wolthers, Ole D.

doi:10.1183/09031936.96.09040821

Cited by 62 publications

(41 citation statements)

References 68 publications

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“…Thus, new therapeutic approaches for the treatment of allergic diseases could be aided by the development of anti-eosinophilic tools. At present, the most effective pharmacological approach for severe eosinophilic reactions, such as asthma, comprises glucocorticoid therapy (4,5). However, steroids display a wide range of unwanted side effects.…”

mentioning

confidence: 99%

Cutting Edge: Lipoxin (LX) A4 and Aspirin-Triggered 15-Epi-LXA4 Block Allergen-Induced Eosinophil Trafficking

Bandeira‐Melo

Bozza

Diaz

et al. 2000

The Journal of Immunology

110

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Tissue eosinophilia prevention represents one of the primary targets to new anti-allergic therapies. As lipoxin A4 (LXA4) and aspirin-triggered 15-epi-LXA4 (ATL) are emerging as endogenous “stop signals” produced in distinct pathologies including some eosinophil-related pulmonary disorders, we evaluated the impact of in situ LXA4/ATL metabolically stable analogues on allergen-induced eosinophilic pleurisy in sensitized rats. LXA4/ATL analogues dramatically blocked allergic pleural eosinophil influx, while concurrently increasing circulating eosinophilia, inhibiting the earlier edema and neutrophilia associated with allergic reaction. The mechanisms underlying this LXA4/ATL-driven allergic eosinophilia blockade was independent of mast cell degranulation and involved LXA4/ATL inhibition of both IL-5 and eotaxin generation, as well as platelet activating factor action. These findings reveal LXA4/ATL as a novel class of endogenous anti-allergic mediators, capable of preventing local eosinophilia.

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mentioning

confidence: 99%

Cutting Edge: Lipoxin (LX) A4 and Aspirin-Triggered 15-Epi-LXA4 Block Allergen-Induced Eosinophil Trafficking

Bandeira‐Melo

Bozza

Diaz

et al. 2000

The Journal of Immunology

110

View full text Add to dashboard Cite

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“…In another study (56) , comprising 43 youngsters with mild asthma and ages between 7 and 14 years, the same authors observed that only the use of 800µg/day of budesonide caused a decrease in leg growth. In a third study (57) , they compared the use of 200µg/day of fluticasone with beclometasone dipropionate at doses of 400 e 800µg/day, in 19 children and adolescents aged from 7 to 14 years.…”

Section: Inhaled Corticosteroids and Growthmentioning

confidence: 81%

“…Measurements are usually made once a week, allowing to demonstrate and quantify the influence of a given drug on growth. This method, however, does not allow to make a prognosis about adult height (52)(53)(54) .…”

Section: Inhaled Corticosteroids and Growthmentioning

confidence: 99%

Linear growth in asthmatic children

et al. 2003

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Asthma is the most frequent chronic inflammatory disease in childhood, and its prevalence has increased remarkably over the last decades. Therefore, the scientific community became interested in studying the growth of the affected children. The relationship between asthma and growth suffers the influence of the clinical picture, of therapeutics, but the different study methods make it difficult to distinguish the factors responsible for the growth retardation detected by some authors. This review has the purpose of providing an overall outlook on this matter. (J Pneumol 2003;29(1):36-42)

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“…This short-term measure bears no relation to intermediate-or longterm growth of statural height. 15,16 Side effects such as adrenal suppression or effects on growth can be studied only through appropriate clinical measurements of adrenal function or height. Our finding of definite systemic steroid activity makes future studies of growth and adrenal function in young children on ICS imperative.…”

Section: Discussionmentioning

confidence: 99%

Systemic Activity of Inhaled Steroids in 1- to 3-Year-Old Children With Asthma

Anhøj

Bisgaard

2002

Pediatrics

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ABSTRACT. Objective. To study the systemic activity of inhaled steroids in young children.Methods. Forty children with mild asthma aged 1 to 3 years were studied in a 3-way crossover, randomized, placebo-controlled, double-blind trial. Treatment with inhaled fluticasone propionate, 200 g twice daily delivered via pressurized metered-dose inhaler (pMDI) and Babyhaler (FP400), was compared with budesonide, 200 g twice daily delivered via pMDI and NebuChamber (BUD400), and to placebo. The Babyhaler was primed before use. Knemometry was used to detect systemic steroid activity. It was performed with a handheld knemometer after 1 and 4 weeks of treatment. The increase in lower-leg length within this 3-week period was used as the outcome measure. The intention-to-treat population was analyzed by analysis of variance.Results. The increases in the lower-leg length during placebo, BUD400, and FP400 treatments were 85, 45, and 34 m/d, respectively (adjusted mean). The growth in lower-leg length was significantly reduced from both steroid treatments. The difference between BUD400 and placebo was ؊40 m/d (n ‫؍‬ 25; 95% confidence interval [CI]: ؊8 to ؊72). The difference between FP400 and placebo was ؊51 m/d (n ‫؍‬ 26; 95% CI: ؊19 to ؊83). The difference between FP and BUD was ؊11 m/d and was not statistically significant (n ‫؍‬ 28; 95% CI: 20 to ؊42).Conclusion. FP and BUD are both systemically active in children 1 to 3 years old when administered for 4 weeks from their dedicated spacer devices in daily doses of 400 g with no difference between the 2 steroid regimens. These findings call for studies of clinical side effects from these treatments of preschool children. Pediatrics 2002;109(3). URL: http://www.pediatrics.org/ cgi/content/full/109/3/e40; inhaled corticosteroid, young child, knemometry, side effects, systemic effects.ABBREVIATIONS. ICS, inhaled corticosteroids; BUD, budesonide; FP, fluticasone propionate; pMDI, pressurized metereddose inhaler; RCT, randomized, controlled trial; Plac, placebo. I nhaled corticosteroids (ICS) are effective treatments for asthma in young children. Budesonide (BUD) and fluticasone propionate (FP) administered from pressurized metered-dose inhalers (pMDIs) and spacer devices have shown beneficial clinical improvements in 0-to 3-year-old children with asthma in randomized, controlled trials (RCTs) of health outcomes, 1-4 lung function and bronchial hyperreactivity, 5 and measurements of the inflammatory marker nitric oxide in exhaled air. 6 Therefore, the Global Initiative on Asthma International Guidelines recommend using ICS as controller treatment in young children with asthma with persistent symptoms. 7 Side effects are of concern for any chronic drug therapy in pediatrics, especially ICS. 8 Recent reassuring data have suggested that long-term treatment of schoolchildren with inhaled BUD for an average of 9 years does not affect final height. 9 However, some aspects of the assessment of safety are unique to preschool children, including the rapid growth velocity and somewhat dif...

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Long-, intermediate- and short-term growth studies in asthmatic children treated with inhaled glucocorticosteroids

Cited by 62 publications

References 68 publications

Cutting Edge: Lipoxin (LX) A4 and Aspirin-Triggered 15-Epi-LXA4 Block Allergen-Induced Eosinophil Trafficking

Cutting Edge: Lipoxin (LX) A4 and Aspirin-Triggered 15-Epi-LXA4 Block Allergen-Induced Eosinophil Trafficking

Linear growth in asthmatic children

Systemic Activity of Inhaled Steroids in 1- to 3-Year-Old Children With Asthma

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