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Methodology and implications of knemometry in growth assessment of inhaled glucocorticoids
Author(s) -
Wolthers O. D.
Publication year - 2010
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/j.1399-3038.2009.00882.x
Subject(s) - medicine , crossover study , placebo , inhalation , term (time) , crossover , washout , double blind , asthma , pediatrics , anesthesia , pathology , physics , alternative medicine , quantum mechanics , artificial intelligence , computer science
Wolthers OD. Methodology and implications of knemometry in growth assessment of inhaled glucocorticoids.
Pediatr Allergy Immunol 2010: 21: e190–e198.
© 2009 The Author
Journal compilation © 2009 Blackwell Munksgaard When validated recommendations for standardization and measurement procedures are used short‐term assessment of lower leg growth by knemometry is a highly accurate and reproducible method for assessment of systemic activity of inhaled glucocorticoids. Crossover and parallel designs applying consistent measurement intervals can be used. Crossover designs with a single‐blind run in and washout and double‐blind active periods are as sensitive as designs using randomized placebo periods. In populations of children, short‐term knemometry appears to be capable of defining specific glucocorticoids, application devices and doses that do not suppress long‐term height growth. Although no specific cut‐off level can be identified in individuals from the available randomized, double‐blind short‐term knemometry and intermediate‐term height growth rate studies, good evidence have been provided that if the short‐term lower leg growth suppression in populations of children is higher than approximately 25%, the risk of intermediate‐term growth suppression becomes significant with a mean height growth rate retardation in the range of approximately 0.5–1.5 cm during the first year of treatment. Short‐term knemometry should be performed as an integral part of the safety assessments of new inhaled glucocorticoids and inhalation devices in children with asthma, before intermediate‐term height growth evaluations are initiated.