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Fluticasone and beclometasone: what are their effects on children's growth?
Kawaljeet Saini1, Peter Griffiths
1King's College London. anusaini26@hotmail.com
Insights
Inhaled fluticasone may be a safer asthma treatment for children. Studies show inhaled fluticasone had less impact on growth velocity compared to inhaled beclometasone in children with asthma.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
Background:
- Inhaled corticosteroids (ICS) are effective asthma treatments for children.
- Concerns about growth retardation may lead to underuse of ICS.
- Newer ICS agents with lower bioavailability may offer improved safety profiles.
Purpose of the Study:
- To compare the effects of inhaled fluticasone and inhaled beclometasone on growth velocity in pre-pubertal children with asthma.
- To assess if inhaled fluticasone has a reduced impact on growth compared to beclometasone.
Main Methods:
- Systematic review of two double-blind, randomized controlled trials.
- Outcome measure: growth velocity in centimeters per year.
- Participants: pre-pubertal children diagnosed with asthma.
Main Results:
- In one study, mean growth velocity was 0.7 cm/year greater in the fluticasone group than the beclometasone group.
- In a second, smaller study, mean growth velocity was 0.8 cm/year greater in the fluticasone group.
- These findings suggest a potential growth-sparing effect of fluticasone.
Conclusions:
- Inhaled fluticasone demonstrates less adverse effect on growth velocity in pre-pubertal children with asthma compared to inhaled beclometasone.
- Fluticasone may alleviate concerns regarding growth suppression, potentially improving ICS adherence in pediatric asthma management.
Abstract:
Fear of growth retardation may account for the underuse of inhaled corticosteroids in children with asthma, despite compelling evidence of their effectiveness. This fear may be reduced with newer agents with lower oral bioavailability if their theoretical advantage of fewer systemic adverse effects than the standard treatment of inhaled beclometasone is realized in practice. This review aims to determine if one of the newer agents, inhaled fluticasone, has less effect on the growth of pre-pubertal asthmatic children than inhaled beclometasone. The outcome measure was growth velocity. Two double blind, randomized controlled trials were identified. In one of the studies the mean growth velocity in the fluticasone group was 0.7 cm/year greater than in the beclometasone group. In the second, smaller study the mean growth velocity in the fluticasone group was 0.8 cm/year greater. There is therefore some evidence that fluticasone has less (if any) adverse effect on growth.