The effect of inhaled budesonide on adrenal and growth suppression in asthmatic children

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K N Priftis1, A Papadimitriou, E Gatsopoulou

  • 1Dept of Allergology-Pulmonology, Penteli Children's Hospital, Greece. kpriftis@otenet.gr

The European Respiratory Journal
|February 3, 2006
PubMed

Insights

Long-term inhaled corticosteroid use in children with asthma may cause mild adrenal suppression, but this is not predictable by growth retardation. Growth effects diminish with longer treatment duration.

Area of Science:

  • Pediatric Endocrinology
  • Respiratory Medicine
  • Pharmacology

Background:

  • Asthma management in children frequently involves inhaled corticosteroids (ICS).
  • Long-term ICS use raises concerns about potential adrenal suppression and growth impacts.
  • Assessing adrenal reserve and growth parameters is crucial in pediatric asthma patients.

Purpose of the Study:

  • To evaluate adrenal reserve in asthmatic children receiving long-term inhaled budesonide.
  • To determine if growth retardation can predict adrenal suppression in these children.
  • To investigate the relationship between ICS treatment parameters and adrenal function/growth.

Main Methods:

  • A low-dose synacthen test was performed on 72 asthmatic children on inhaled budesonide and 30 controls.
  • Peak serum cortisol levels were measured; adrenal suppression defined as <495 nmol/L.
  • Height standard deviation score (HSDS) and height velocity SDS (HVSDS) were calculated.

Main Results:

  • Adrenal suppression was observed in 20.8% of asthmatic children.
  • No significant differences in HSDS or HVSDS were found between suppressed and non-suppressed groups.
  • A positive correlation was noted between HVSDS and treatment duration, suggesting reduced growth impact over time.

Conclusions:

  • Low-to-moderate dose inhaled budesonide in asthmatic children can lead to mild adrenal suppression.
  • Growth deceleration does not reliably predict adrenal suppression in this cohort.
  • The negative impact of ICS on growth appears to lessen with longer treatment duration.

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