Inhaled corticosteroid treatment and growth of asthmatic children seen at outpatient clinics

Arend, Elisete E.; Fischer, Gilberto Bueno; Debiasi, Márcio; Schmid, Helena

doi:10.2223/jped.1486

Cited by 17 publications

(15 citation statements)

References 25 publications

(28 reference statements)

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“…Arend et al, 43 in a longitudinal prospective study, years, were included. There was no difference in the physical activity level among children who had had sibilation crises and the ones who had never had them.…”

Section: Prospective Studiesmentioning

confidence: 99%

Obesidade e asma: associação ou coincidência?

Camilo¹,

Ribeiro²,

Toro³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: Asthma and obesity are among the major causes of morbidity in childhood and adolescence. Early obesity increases the chances of chronic degenerative diseases in adults. Although the concomitance or both clinical situations are being demonstrated in various studies, the intrinsic mechanisms of this association are still very little known. Therefore, the objective of this article was to review the main studies on the association of obesity and asthma and check if there is a cause-effect relation between them.Sources: Systematic review based on indexed data bases MEDLINE (PubMed) and SciELO. Original articles (cross-sectional, case-control, and prospective studies) and meta-analysis published in the period that ranges from January 1998 to January 2008 were reviewed. Studies published in English, Spanish, and Portuguese were researched. Summary of the findings:Although there are various studies on growing prevalence of asthma and obesity, few of them establish cause-effect relations between them. Physiopathological mechanisms and factors involved in this process are still little known. Conclusion:Methodological rigor in future studies must seek for answers to better understand if there is association between asthma and obesity or if the relationship between both diseases is a coincidence.

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Section: Prospective Studiesmentioning

confidence: 99%

Obesidade e asma: associação ou coincidência?

Camilo¹,

Ribeiro²,

Toro³

et al. 2010

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

show abstract

“…Bone Mineral Density (BMD) is a sensitive marker of the effects of corticosteroids on bone and can be used to predict the fracture risk (24). Decreased BMD has been demonstrated with high doses of ICS but not with low to medium doses (25,26). A study on 48 prepubertal children aged 5 to 14 years who were on 400 to 2000 µg/day of beclomethasone dipropionate Metered Dose Inhaler (MDI) has shown slow BMD acquisition in children who were on high doses and no effects with low to moderate doses (27).…”

Section: Ics and Growthmentioning

confidence: 99%

Effect Of Long Term Inhaled Corticosteroid Therapy On Adrenal Suppression, Growth And Bone Health In Children With Asthma

Anuradha

Prematilake

Batuwita

et al. 2019

Preprint

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EFFECT OF LONG TERM INHALED CORTICOSTEROID THERAPY ON ADRENAL SUPPRESSION, GROWTH AND BONE HEALTH IN CHILDREN WITH ASTHMA Anuradha KWDA1, Prematilake GLDC2, Batuwita BAUI3, Kannangoda KASR4, Hewagamage US5,Wijeratne S6, Lankatilake Kantha7, de Silva KSH8 Abstract Background Primary objective was to describe the effect of long term inhaled corticosteroid therapy (ICS) on adrenal suppression, growth and bone health in children with Asthma. Secondary objectives were to describe the association between the dose of ICS and duration of therapy on adrenal functions, growth and bone health in children with asthma, describe their growth ,biochemical parameters associated with bone health and vitamin D levels in comparison to an age and sex matched group of children with asthma who were not on long term ICS. Method Seventy children with asthma on ICS and 70 controls were studied. The estimated adult heights were interpreted relative to their Mid Parental Height (MPH) range. Serum calcium, alkaline phosphatase and vitamin D levels were assayed in both groups and cortisol value at 30 minutes following a low dose short synacthen test was obtained from the study group. The average daily dose of ICS was categorized as low, medium and high (100-200, 200-400, >400 ug /day ) respectively according to published literature. Results Heights of all children were within the MPH range. There was no statistically significant difference in the bone profiles and vitamin D levels between the two groups (Ca: p=0.554, vitamin D: p=0.187) but vitamin D levels were insufficient (<50 nmol/l) in 34% of cases and 41% of controls. Suppressed cortisol levels were seen in 24%. Doses of ICS were low, medium and high in 56%, 32% and 12% of children respectively. The association between adrenal suppression with longer duration of therapy (p<0.01) and with increasing dose of ICS (p<0.001) were statistically significant. Conclusion ICS had no impact on the growth and bone profiles but its dose and duration were significantly associated with adrenal suppression. Key Words- Asthma, Inhaled corticosteroids, Growth, Adrenal suppression, Bone Metabolism, Vitamin D

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“…Bone Mineral Density (BMD) is a sensitive marker of the effects of corticosteroids on bone and can be used to predict the fracture risk (25). Decreased BMD has been demonstrated with high doses of ICS but not with low to medium doses (26,27). A study on 48 prepubertal children aged 5 to 14 years who were on 400 to 2000 µg/day of beclomethasone dipropionate Metered Dose Inhaler (MDI) has shown slow BMD acquisition in children who were on high doses and no effects with low to moderate doses (28).…”

Section: Ics and Growthmentioning

confidence: 99%

Effect Of Long Term Inhaled Corticosteroid Therapy On Adrenal Suppression, Growth And Bone Health In Children With Asthma

Anuradha

Prematilake

Batuwita

et al. 2019

Preprint

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Background Inhaled corticosteroids(ICS) are the most effective treatment for children with persistent asthma .However adverse effects of ICS on Hypothalamo Pituitary Adrenal (HPA) axis, growth and bone metabolism are a concern. Hence the primary objective of this study was to describe the effects of long term inhaled corticosteroid therapy (ICS) on adrenal function, growth and bone health in children with asthma in comparison to an age and sex matched group of children with asthma who were not on long term ICS. .Describing the association between the dose of ICS and duration of therapy on the above parameters were secondary objectives. Method Seventy children with asthma on ICS and 70 controls were studied. Diagnosis of asthma in selected patients was reviewed according to the criteria laid down by GINA 2018 guidelines .The estimated adult heights were interpreted relative to their Mid Parental Height (MPH) range. Serum calcium, alkaline phosphatase and vitamin D levels were analyzed in both groups and cortisol value at 30 minutes following a low dose short synacthen test was obtained from the study group. The average daily dose of ICS (Beclamethasone) was categorized as low, medium and high (100-200, 200-400, >400 ug /day) respectively according to published literature. Results Heights of all children were within the MPH range. There was no statistically significant difference in the bone profiles and vitamin D levels between the two groups (Ca: p=0.554, vitamin D: p=0.187) but vitamin D levels were insufficient (<50 nmol/l) in 34% of cases and 41% of controls. Suppressed cortisol levels were seen in 24%. Doses of ICS were low, medium and high in 56%, 32% and 12% of children respectively. The association between adrenal suppression with longer duration of therapy (p<0.01) and with increasing dose of ICS (p<0.001) were statistically significant. Conclusion ICS had no impact on the growth and bone profiles but its dose and duration were significantly associated with adrenal suppression. Key Words- Asthma, Inhaled corticosteroids, Growth, Adrenal suppression, Bone Metabolism, Vitamin D

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Inhaled corticosteroid treatment and growth of asthmatic children seen at outpatient clinics

Abstract: In comparison with the NCHS (National Center for Health Statistics) growth curves, there was no compromise to the height or body weight of children/adolescents using inhaled corticosteroids for more than 1 year at the doses recommended for asthma prevention.

Cited by 17 publications

References 25 publications

Obesidade e asma: associação ou coincidência?

Obesidade e asma: associação ou coincidência?

Effect Of Long Term Inhaled Corticosteroid Therapy On Adrenal Suppression, Growth And Bone Health In Children With Asthma

Effect Of Long Term Inhaled Corticosteroid Therapy On Adrenal Suppression, Growth And Bone Health In Children With Asthma

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