Last Updated: 2001-07-30 14:27:37 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) – Children under 5 years who start treatment with inhaled corticosteroids for asthma require long-term growth monitoring, reports a team of researchers in Ankara, Turkey.
To evaluate the effects of fluticasone propionate on growth and adrenocortical function in young children, Dr. Ipek Turktas and colleagues from the Gazi University Faculty of Medicine performed an open, prospective study for 24 weeks.
As reported in the Annals of Allergy, Asthma and Immunology for June, the study population consisted of 20 asthmatic children, male and female, from 2.5 to 5.0 years of age, who had been receiving fluticasone. They received fluticasone by metered dose inhaler, four puffs (50 µg/puff) twice daily with a large-volume spacer. Eighteen non-asthmatic children, matched for age, were recruited as a comparison group.
When Dr. Turktas and colleagues compared individual pretreatment and post-treatment height standard deviation scores, they noted "a significant increase in two children, a slight decrease in two children, and a significant decrease in six children; no change was noted in height standard deviation scores in 10 patients."
The mean height standard deviation score decreased from 0.44 at baseline to 0.28 at week 18 (p = 0.01 compared with controls) and 0.25 at week 24 (p = 0.04). Adrenocortical function, as determined by serum cortisol concentration, was not measurably altered in the fluticasone group versus the control group.
"The long-term effects of inhaled corticosteroids on final growth in children who begin [this therapy] at less than 5 years of age have not been reported," note the researchers. Based on their findings in this short-term study, they conclude that "growth should be regularly monitored in children younger than 5 years if inhaled corticosteroid therapy is begun for mild persistent asthma."
Ann Allergy Asthma Immunol;86:649-654.
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