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[Effects of inhaled beclomethasone on height growth and bone metabolism in children with asthma]
1Department of Pediatric Allergy, Osaka Prefectural Habikino Hospital.
Insights
Inhaled beclomethasone dipropionate (BDP) may slightly suppress height growth in children with asthma at higher doses. Bone metabolism remained unaffected in this 6-month study.
Area of Science:
- Pediatric Pulmonology
- Pediatric Endocrinology
- Pharmacology
Context:
- Asthma management in children requires careful consideration of medication side effects.
- Inhaled corticosteroids are a cornerstone of asthma therapy, necessitating long-term safety evaluations.
- Growth and bone health are critical parameters in pediatric pharmacotherapy.
Purpose:
- To assess the impact of inhaled beclomethasone dipropionate (BDP) on bone metabolism and linear growth in pediatric asthma patients.
- To determine dose-dependent effects of BDP on bone mineral density and osteocalcin levels.
- To evaluate potential height suppression associated with BDP therapy in children.
Summary:
- A 6-month longitudinal study involved 34 children (3-15 years) with asthma receiving BDP (7.3-30.9 µg/kg/day).
- Bone mineral density (via digital image processing) and serum osteocalcin showed no significant changes.
- A slight suppression in height growth was observed in patients receiving >15 µg/kg/day of BDP.
Impact:
- Findings suggest a potential risk of growth suppression with higher doses of inhaled BDP, requiring clinical vigilance.
- The study underscores the importance of balancing therapeutic benefits against potential adverse effects in pediatric asthma management.
- Informed clinical decisions regarding inhaled corticosteroid prescription should weigh efficacy and quality of life improvements against possible side effects like growth impairment.
Abstract:
To evaluate the influences of inhaled beclomethasone dipropionate (BDP), 7.3-30.9 (15.5 +/- 6.5) micrograms/kg/day, on bone metabolism and height growth, we performed a longitudinal study for 6 months in 34 children with asthma aged between 3 and 15 years. Bone mineral density estimated by digital image processing method (DIP) and serum level of osteocalcin did not show any significant change, but height growth was slightly suppressed in the patients who inhaled more than 15 micrograms/kg/day of BDP. We concluded that the decision to prescribe inhaled BDP should be made on the balance of the clinical effects and the improvement of quality of life against the possibility of side effects.