Return
Inhaled Corticosteroids Don't Slow
Growth in Toddlers With Asthma
The inhaled steroid medicine fluticasone propionate
(FP) effectively controls wheezing and reduces airway inflammation in children
with asthma, but there's
some concern that the medication could cause growth impairment, as has been
reported in some studies of children. Researchers from the United States
(Wisconsin), Denmark, Poland, Bulgaria, and the United Kingdom studied the
effectiveness and side effects of FP versus treatment with another standard
asthma drug in a group of toddlers.
Six hundred twenty-five 1- to 3-year-olds with
repeated wheezing were randomly assigned to receive either FP or sodium
cromoglycate (SCG) for 1 year. The children in the study took either FP or SCG
via inhaler each day and continued to use quick-relief asthma medications as
needed. For 21 of the 52 study weeks, parents completed daily records of their
children's wheezing symptoms and use of quick-relief asthma medications. The
children in the study underwent regular checkups at health clinics. At each
clinic visit, the child's height and weight were measured.
When the growth rates between the two treatment
groups were compared, there were no significant differences. There were no
serious side effects with either medication; cough and hoarseness were the most
common side effects with both medications, affecting less than 2% of the
children in the study.
When it came to controlling asthma symptoms, FP was
more effective than SCG. Children taking FP were less likely to have asthma
flares and need quick-relief medications. Children taking FP also had more days
without any asthma symptoms.
What This Means to You:
According to the results of this study, FP is a relatively
effective and safe inhaled treatment for toddlers with asthma, despite concerns
that FP could cause growth impairment, as has been observed in studies of older
children. If you have any questions about your child's asthma medication or
asthma management plan, talk to your child's doctor or asthma
specialist.
Source: Hans Bisgaard, MD; David Allen, MD; Janusz
Milanowski, MD; Ilia Kalev, MD; Lisa Willits, MSc; Patricia Davies, PhD;
Pediatrics, February 2004
Reviewed by: Steven
Dowshen, MD
Date reviewed: March
2004