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A longitudinal assessment of the effect of inhaled fluticasone propionate therapy on adrenal function and growth in young children with asthma
Author(s) -
Iles R.,
Williams R. W.,
Deeb A.,
RossRussell R.,
Acerini C.L.
Publication year - 2008
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20770
Subject(s) - medicine , fluticasone propionate , fluticasone , asthma , wheeze , body mass index , corticosteroid , morning , adverse effect , pediatrics , gastroenterology , endocrinology
Objective Fluticasone proprionate (FP) is increasingly used to treat very young children with asthma. Its safety in terms of effects on the hypothalamic pituitary axis (HPA) and growth in this age group is uncertain. Patients and methods: Eleven children (median (range) age 10 (5.6–24.3) months) presenting with recurrent wheeze and family history of asthma were studied prospectively for a period of 18 months. Children received daily‐inhaled FP 250 µg via a spacer device. No other corticosteroid therapy was administered prior to or during the study. A Short Standard Synacthen Test (SST) (125 µg) was performed pretreatment, and after 6 and 18 months. Weight (Wt), height (Ht), and body mass index (BMI) were measured at 3–6 monthly intervals. Results: Fasting early morning and peak cortisol levels remained within the normal reference range with therapy. There were no changes in Ht SDS, whereas both Wt SDS (baseline 0.05 (−2.17 to 0.52) vs. +18 months 0.68 (−0.5 to 1.36) P < 0.02) and BMI SDS (−0.22 (−1.73 to 0.75) vs. 0.86 (0.03 to 1.99) P < 0.005) increased after 18 months of treatment. Conclusion: Daily treatment with inhaled FP 250 µg in young children with asthma appears to have no adverse effects on the HPA or on linear growth, however, treatment is associated with increases in body Wt and BMI in young children. Pediatr Pulmonol. 2008; 43:354–359. © 2008 Wiley‐Liss, Inc.