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Growth and adrenal responsiveness with budesonide in young asthmatics
1Department of Child Health, King's College School of Medicine and Dentistry, London, U.K.
Insights
Inhaled corticosteroid therapy in young children with asthma does not appear to cause significant systemic side effects. Budesonide treatment showed no adverse impact on growth or adrenal function in preschool-aged children.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Endocrinology
Background:
- Inhaled corticosteroid (ICS) use for asthma is increasing in preschool children.
- Existing data on ICS adverse effects primarily comes from studies on older children.
- Systemic effects of ICS in very young children require further investigation.
Purpose of the Study:
- To assess the systemic effects of inhaled budesonide in preschool-aged asthmatic children.
- To evaluate the impact of budesonide on growth velocity and bone age.
- To determine if young children exhibit increased susceptibility to ICS side effects.
Main Methods:
- Studied 18 asthmatic children (4.5-7.4 years) treated with budesonide via Nebuhaler.
- Measured height velocities over one year of treatment.
- Assessed bone age and adrenal function (tetracosactrin response).
Main Results:
- Height velocities were comparable to normal population values.
- No dose-related effect of budesonide on height velocity or bone age was observed.
- All children showed normal adrenal response to tetracosactrin.
Conclusions:
- Young asthmatic children treated with inhaled budesonide do not exhibit greater susceptibility to systemic effects compared to older children.
- Budesonide at doses of 200-1100 micrograms m-2 day-1 appears safe regarding growth and adrenal function in this age group.
Abstract:
Inhaled corticosteroid therapy for asthma is used increasingly from a pre-school age. Current knowledge of adverse systemic effects, however, is based on treatment of older children. Eighteen asthmatic children aged 4.5-7.4 years who had taken budesonide by Nebuhaler in doses averaging 200-1100 micrograms m-2 day-1 during the previous year were studied. Height velocities calculated over this period were no different from those of the normal population. Neither the velocities nor a modest delay in bone ages were related to budesonide dose. Every child responded normally to tetracosactrin. These young asthmatic children do not show a greater susceptibility to systemic effects from an inhaled corticosteroid than older counterparts.