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[Fluticasone in the therapy of asthmatic children: short-term effects on growth]
E Bozzola1, C Meazza, F Prodam
1Dipartimento di Scienze Pediatriche, Fondazione IRCCS San Matteo, Pavia, Italia. mauro.bozzola@unipv.it
Insights
Low-dose inhaled corticosteroids (ICS) like fluticasone do not impact short-term growth in children with asthma. This study found no negative effects on growth rate in prepubertal children using ICS with a spacer.
Area of Science:
- Pediatric Pulmonology
- Pharmacological Safety
- Growth and Development
Context:
- Inhaled corticosteroids (ICS) are standard therapy for mild-to-moderate asthma, improving lung function and quality of life.
- Concerns exist regarding potential side effects, particularly growth suppression, in children undergoing long-term ICS treatment.
- Existing clinical trials primarily focus on efficacy, leaving safety data, especially concerning short-term auxological development, less defined.
Purpose:
- To assess the short-term impact of spacer-administered inhaled corticosteroid (fluticasone dipropionate) therapy on the auxological development of prepubertal children.
- To investigate whether low-dose ICS influences growth rate in children with mild asthma.
Summary:
- A six-month study evaluated height and weight changes in prepubertal children with mild asthma receiving 100 mcg/day of fluticasone dipropionate via a spacer.
- Results showed no negative influence on short-term growth rate in either younger (5.5 years) or older (10.0 years) prepubertal children.
- Growth remained regular in the younger group (0.8 SDS pre- and post-therapy) and showed an increment in the older group (0.5 SDS to 0.7 SDS).
Impact:
- Provides evidence that low-dose, spacer-administered fluticasone is safe for short-term growth in prepubertal children.
- Informs clinical practice regarding the safety profile of ICS in pediatric asthma management.
- Contributes to a better understanding of ICS side effects, specifically addressing growth concerns in young asthmatic patients.
Aim:
Inhaled corticosteroids (ICS), for years used in the therapy of low-moderate bronchial asthma, reduce the rate of asthmatic attack with improved pulmonary functioning and quality of life. Clinical trials have been addressed mainly to study the efficacy rather than the safety of drugs, so that the side effects of these drugs have not yet been accurately defined. Clinical experience shows that growth delay appears in the first months of therapy with ICS. The aim of the study was to evaluate the influence of the therapy with spacer-administered inhaled corticosteroid on short-term auxological development in prepubertal children.
Methods:
In a group of children with low asthma, height and weight have been evaluated before and after six months of inhaled therapy with dipropionate fluticasone at a dose of 100 microg per day.
Results:
Twenty-five patients (19 males and 6 females; age 5.5+/-1.6 years; range: 2.6-7.8 years) showed a regular growth during the six months of therapy (mean height 0.8 standard deviation score [SDS] before therapy and 0.8 SDS after therapy), while 21 (17 males and 4 females; age 10.0+/-1.5 years; range 8.0-12.7 years) showed an increment of growth rate (mean height from 0.5 SDS to 0.7 SDS, respectively).
Conclusion:
Spacer-administered low dose fluticasone does not negatively influence short-term growth rate, regardless of the age of the patients.
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