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Fluticasone propionate in children with moderate asthma
M O Hoekstra1, M H Grol, K Bouman
1Groningen Institute for Drug Studies, Beatrix Children's Clinic, Groningen, the Netherlands.
American Journal of Respiratory and Critical Care Medicine
|October 1, 1996
Summary
Fluticasone propionate (FP) effectively treats moderate childhood asthma, improving lung function and reducing symptoms. While generally safe, further studies are needed to definitively rule out HPA-axis suppression with this inhaled corticosteroid.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Endocrinology
Background:
- Inhaled corticosteroids (ICS) are standard for pediatric asthma management.
- Potential HPA-axis influence by ICS requires investigation.
- Fluticasone propionate (FP) is a commonly used ICS.
Purpose of the Study:
- To evaluate the efficacy and safety of fluticasone propionate (FP) 100 mcg twice daily in children with moderate asthma.
- To assess the impact of FP on HPA-axis function via serum and urinary cortisol levels.
Main Methods:
- Double-blind, randomized, placebo-controlled trial.
- 34 children with moderate asthma participated.
- Evaluated lung function, PEFR, symptoms, serum, and urinary cortisol over 3 months.
Main Results:
- FP significantly reduced wheezing and improved PEFR and FEV1.
- Lung function parameters returned to baseline after FP cessation.
- No significant change in serum cortisol; urinary cortisol decrease was borderline significant compared to placebo.
Conclusions:
- FP 100 mcg twice daily is effective for moderate pediatric asthma.
- HPA-axis suppression is unlikely but cannot be entirely excluded due to study limitations.
- Further research is recommended to clarify potential HPA-axis effects.