Assessment of the relation between short and intermediate term growth in children with asthma treated with inhaled glucocorticoids

• Published in: Allergy (Copenhagen) Vol. 59; no. 11; pp. 1193 - 1197
• Main Authors: Wolthers, O. D., Heuck, C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.11.2004; Blackwell; Blackwell Publishing Ltd
• Subjects: Administration, Inhalation; Adolescent; Allergic diseases; Anthropometry; Asthma; Asthma - drug therapy; Biological and medical sciences; Body Size - drug effects; budesonide; Budesonide - administration & dosage; Budesonide - adverse effects; Child; Child Development - drug effects; Children & youth; Drug therapy; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; growth; Humans; Immunopathology; inhaled glucocorticoids; knemometry; Leg - growth & development; Male; Medical sciences; Physical growth; Powders; Steroids; Time Factors; Human; Short term; Steroid; Corticosteroid; Lung disease; Allergy; Budesonide; Immunopathology; Respiratory disease; Antiinflammatory agent; budesonide: growth; Glucocorticoid; knemometry; Asthma; Inhalation; Immunology; Bronchus disease; inhaled glucocorticoids; steroids; Obstructive pulmonary disease; Child
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/j.1398-9995.2004.00541.x

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 μg 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 μg/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.