No effect of fluticasone propionate on linear growth in preschool children with asthma

• Published in: Pediatrics international 2011-10, Vol.53 (5), p.672-676
• Main Authors: Stefanovic, Iva M., Verona, Eva, Cicak, Biserka, Vrsalovic, Renata
• Format: Article
• Language: English
• Subjects: Adrenal glands; Adrenocorticotropic Hormone - blood; adverse effect; Androstadienes - therapeutic use; Anti-Asthmatic Agents - therapeutic use; Anti-Inflammatory Agents - therapeutic use; Asthma; Asthma - drug therapy; Asthma - physiopathology; Bronchodilator Agents - therapeutic use; Child, Preschool; children; Female; Fluticasone; fluticasone propionate; growth; Growth - drug effects; Human growth; Humans; Hydrocortisone - blood; Hypothalamo-Hypophyseal System - drug effects; Male; Pituitary-Adrenal System - drug effects; Preschool children; Steroids
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/j.1442-200X.2011.03334.x

Background:  Eighty percent of asthmatic children develop asthma symptoms by the age of 5 years. Inhaled corticosteroids (ICS), depending on dosage, may cause linear growth reduction and adrenal gland suppression. There are few studies about linear growth of preschool children with asthma. The aim of the present study was to investigate whether there is any effect of fluticasone propionate (FP) on linear growth and adrenal gland function. Methods:  Twenty‐eight children aged 18–52 months with persistent asthma receiving ICS FP 100–200 µg daily were studied for 1 year. Patients were divided into two groups according to clinical parameters: well (group 1) and poorly controlled (group 2). Height was measured every 3 months and expressed as height standard deviation score (SDS). Cumulative dose of FP expressed in mg was calculated for every patient. Early morning levels of serum adrenocorticotropic hormone (ACTH) and cortisol were assessed at the beginning and at the end of the study. Results:  Patients took FP for an average of 11 months in group 1 and 16 months in group 2, which was not statistically significantly different. At the end of the study height SDS difference was −0.0143 in group 1 and −0.2000 in group 2, which was not statistically significantly different (t= 0.6072, P= 0.5489). There was also no statistically significant difference for average cortisol (P= 0.4381) or ACTH (P= 0.5845) concentration at the end of the study. Conclusion:  FP 100–200 µg daily had no effect on linear growth or on the hypothalamic–pituitary–adrenal gland axis but further follow up is necessary.