Long‐Term Treatment with Beclomethasone Dipropionate Aerosol in Asthmatic Children, with Special Reference to Growth

Graff‐Lonnevig, V.; Kraepelien, Sven

doi:10.1111/j.1398-9995.1979.tb02001.x

Cited by 46 publications

(10 citation statements)

References 13 publications

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“…The direct influence of asthma on growth makes it difficult to assess the effects of corticosteroids in crosssectional studies, although the majority of these studies have shown no effect of inhaled corticosteroids [67][68][69][70][71][72][73][74][75][76]. Longitudinal studies have also generally failed to demonstrate any significant effect of inhaled corticosteroids on statural growth in doses up to 800 µg·day -1 for up to 5 yrs of treatment [62,[77][78][79].…”

Section: Effect Of Corticosteroids On Growthmentioning

confidence: 99%

Effect of inhaled corticosteroids on bones and growth

Efthimiou¹,

Barnes²

1998

Eur Respir J

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Asthma is a chronic inflammatory disease of the airways and current national and international asthma management guidelines advocate the early introduction of inhaled corticosteroids as the most effective anti-inflammatory therapy available [1][2][3][4]. However, inhaled corticosteroids are not entirely devoid of risk and their use in clinical practice entails a judgement that weighs the potential benefits against the risks of treatment [5][6]. The potential for systemic effects of inhaled corticosteroids is considered to be reflected in their activity of suppressing the hypothalamic-pituitary-adrenal (HPA) axis [7]. However, the clinical relevance of such suppression has been questioned [8] and concerns have been raised concerning the possible effects of inhaled corticosteroids on bones [9] and growth [10]. This review examines the effects of inhaled corticosteroids on bone metabolism, bone density and growth in adults and children with asthma, in view of the recent availability of a substantial amount of new information from clinical trials. Effect of corticosteroids on bone metabolismCorticosteroids may lead to a reduction in bone mass and osteopenia via several different mechanisms, including direct effects on bone formation and bone resorption and indirect effects via actions on the pituitary-gonadal and pituitary-adrenal axes, intestinal calcium absorption, renal tubular calcium reabsorption and secondary hyperparathyroidism ( fig. 1) [11]. A number of biochemical markers have been used to assess the short-term effects of inhaled corticosteroids on bone turnover [12] (table 1). Bone formation has been evaluated by measuring blood concentrations of bone-specific alkaline phosphatase, osteocalcin and procollagen type-1 carboxy-terminal and amino-terminal propeptides (P1CP and P1NP, respectively). Bone resorption has been evaluated by measuring urinary excretion of hydroxyproline, calcium and pyridinium cross-links and by serum levels of type-1 carboxy-terminal telopeptide (1CTP) and tartrate-resistant acid phosphatase. Examination of relevant retrospective and prospective data, involving 11 studies (1,240 patients) on biochemical bone markers and 14 studies (373 patients) on bone density over a wide dose range, have largely indicated no significant or clinically important effect on these measurements in adults or children with asthma. Markers of bone formation and resorption need to be measured concurrently for a reliable assessment of bone turnover to be made.Knemometry, measuring lower leg growth rate, is a sensitive technique for comparing the systemic activity of different inhaled corticosteroids, but does not relate to long-term growth. The majority of approximately 40 studies on inhaled corticosteroids and statural growth in children, over a wide recommended dose range, including a number of recent long-term, prospective studies, demonstrate little or no effect. Children taking above recommended doses of inhaled corticosteroids should have their growth monitored using stadiometry at least every 6 month...

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Section: Effect Of Corticosteroids On Growthmentioning

confidence: 99%

Effect of inhaled corticosteroids on bones and growth

Efthimiou¹,

Barnes²

1998

Eur Respir J

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“…'0 11 The effect of ICT on linear growth, is however, controversial. 3 [12][13][14] This study evaluated the effects of ICT and the severity of asthma on linear growth in prepubertal children with severe chronic bronchial asthma, many of whom were poorly controlled despite higher than conventionally recommended doses of ICT.…”

mentioning

confidence: 99%

Asthma, inhaled corticosteroid treatment, and growth.

Ninan

Russell

1992

Archives of Disease in Childhood

142

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To evaluate the effects on growth of inhaled corticosteroid treatment (ICT) and of the quality of control of asthma, height velocity was studied in 58 prepubertal children attending a specialist asthma clinic because of chronic asthma that was difficult to control. The height velocity standard deviation (SD) score was maximal when the asthma was well controlled both before (0-01) and after (-0.07) starting ICT. It was least when the asthma was poorly controlled both before (-1-50) and after (-1-55) starting ICT. The effectiveness of control correlated significantly with the height velocity SD score, both before and after ICT was started. No evidence was found that the administration of ICT has an adverse effect on growth.

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“…Compared with oral corticosteroids, inhaled corticosteroids caused dramatically fewer side effects, specifically appearing not to impair growth [14,15] and possibly resulting in improved growth [16]. However, these studies reported on small numbers of children and were designed to evaluate therapeutic efficacy.…”

Section: Historical Backgroundmentioning

confidence: 97%

Effects of inhaled corticosteroids on growth in asthmatic children

Creese

Doull

2001

Curr Allergy Asthma Rep

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This article presents a brief review of the effects of inhaled corticosteroids on growth in children with asthma. All currently available inhaled corticosteroids, where there is adequate data, have been shown to cause significant growth suppression in children in a dose-dependent manner. It is now apparent that there are differences in the growth-suppressive effects of different corticosteroids. Recent evidence confirms that the growth-suppressive effects are short lived and that, at conventional doses, inhaled corticosteroids do not affect final attained adult height.

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Long‐Term Treatment with Beclomethasone Dipropionate Aerosol in Asthmatic Children, with Special Reference to Growth

Cited by 46 publications

References 13 publications

Effect of inhaled corticosteroids on bones and growth

Effect of inhaled corticosteroids on bones and growth

Asthma, inhaled corticosteroid treatment, and growth.

Effects of inhaled corticosteroids on growth in asthmatic children

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