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Assessment of the relation between short and intermediate term growth in children with asthma treated with inhaled glucocorticoids
Author(s) -
Wolthers O. D.,
Heuck C.
Publication year - 2004
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2004.00541.x
Subject(s) - medicine , asthma , budesonide , pediatrics
Objective: To assess the relation between short‐term growth and intermediate term growth in children with asthma treated with inhaled glucocorticoids. Design: An open 12 months parallel group trial with visits to the clinic on day 1, after 2, 4, 8, 12, 20, 28, 36, 44 and 52 weeks. Setting : Outpatient clinic in a secondary referral centre. Subjects : Sixteen children with asthma aged 9 (6–13) years; 16 matched healthy subjects. Methods: Knemometry and stadiometry. Interventions : Dry‐powder inhaled budesonide 200 μ g twice daily. Primary outcome measures : Intra‐group comparisons of mean lower leg growth rates. Secondary outcome measures : Inter‐group comparisons of mean lower leg growth rates and intra‐group comparisons of mean height‐standard deviation scores. Results: One year mean lower leg growth rate (0.36 mm/week) did not differ from the rates during the 2 (0.27 mm/week; P = 0.23), 4 (0.33 mm/week; P = 0.54), 8 (0.36 mm/week; P = 0.79) or 12 (0.33 mm/week; P = 0.49) weeks intervals in the asthma group. Similarly, in the healthy children 2 (0.56 mm/week; P = 0.63), 4 (0.46 mm/week; P = 0.36), 8 (0.43 mm/week; P = 0.49) and 12 (0.43 mm/week; P = 0.66) weeks mean growth rates did not vary statistically significantly from the 1 year growth rate (0.42 mm/week). Mean lower leg growth rates, however, were consistently lower during all periods in the children with asthma ( P = 0.02–0.03). At completion of the study mean height‐standard deviation score in the asthma group (−0.19) was significantly suppressed as compared with the score at study entry (−0.03) ( P = 0.02), whereas no statistically significant variation was detected in the control group. Conclusions: Short‐term lower leg growth rates are consistent with intermediate term growth rates in group studies in children with asthma treated with inhaled dry powder budesonide 400 μ g/day. Short‐term group knemometry should be an integral part of growth evaluations of new inhaled glucocorticoids, doses and inhalation devices in children with asthma.