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Systemic activity of inhaled steroids in 1- to 3-year-old children with asthma

Jacob Anhøj1, Anne Marie Bisgaard, Hans Bisgaard

  • 1Pulmonary Service, Department of Paediatrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Pediatrics
|March 5, 2002
PubMed

Insights

Inhaled corticosteroids fluticasone propionate (FP) and budesonide (BUD) show systemic activity in young children with asthma. Both FP and BUD reduced leg growth, indicating potential side effects in preschool children.

Area of Science:

  • Pediatric Pulmonology
  • Pharmacology
  • Endocrinology

Background:

  • Inhaled corticosteroids (ICS) are a common treatment for pediatric asthma.
  • Assessing the systemic activity of ICS in young children is crucial for understanding potential growth impacts.

Purpose of the Study:

  • To evaluate the systemic activity of inhaled fluticasone propionate (FP) and budesonide (BUD) in children aged 1 to 3 years.
  • To compare the effects of FP and BUD on growth velocity.

Main Methods:

  • A randomized, double-blind, placebo-controlled crossover trial involving 40 children with mild asthma.
  • Systemic steroid activity was assessed using knemometry to measure lower-leg length growth over 4 weeks.
  • Treatments included FP (400 mcg/day), BUD (400 mcg/day), and placebo, delivered via metered-dose inhalers and spacers.

Main Results:

  • Both FP and BUD significantly reduced lower-leg growth velocity compared to placebo.
  • FP reduced growth by 51 microm/day and BUD by 40 microm/day, with no significant difference between the two steroids.
  • The study analyzed the intention-to-treat population using analysis of variance.

Conclusions:

  • Inhaled fluticasone propionate and budesonide are systemically active in young children (1-3 years) at a daily dose of 400 mcg.
  • These findings highlight the need for further studies on the clinical side effects of these inhaled steroid regimens in preschool children.
Abstract

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