Childhood Asthma and Steroid Therapy as Influences on Growth

Falliers, Constantine J.

doi:10.1001/archpedi.1963.02080040129002

Cited by 61 publications

(38 citation statements)

References 20 publications

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“…The demonstration of normal plasma GH levels in children receiving therapy in doses known to l)e associated with growth retardation (20,21) argues against deficiency of GH as the primary mechanism responsible for dwarfism. Similar studies have shown that children with other nonpituitary forms of dwarfism also have normal levels of GH during fasting and after hypoglycemia (17)(18)(19).…”

Section: Resultsmentioning

confidence: 99%

Plasma growth hormone concentration in corticosteroid-treated children

Morris¹,

Jørgensen²,

Jenkins³

1968

J. Clin. Invest.

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Section: Resultsmentioning

confidence: 99%

Plasma growth hormone concentration in corticosteroid-treated children

Morris¹,

Jørgensen²,

Jenkins³

1968

J. Clin. Invest.

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“…Systemic corticosteroids, even at doses as low as 5 mg·day -1 prednisolone [65], are known to impair growth in children and prior treatment with these may further complicate assessment of growth in children with asthma [63,65,66]. The direct influence of asthma on growth makes it difficult to assess the effects of corticosteroids in crosssectional studies, although the majority of these studies have shown no effect of inhaled corticosteroids [67][68][69][70][71][72][73][74][75][76].…”

Section: Effect Of Corticosteroids On Growthmentioning

confidence: 99%

Effect of inhaled corticosteroids on bones and growth

Efthimiou¹,

Barnes²

1998

Eur Respir J

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Asthma is a chronic inflammatory disease of the airways and current national and international asthma management guidelines advocate the early introduction of inhaled corticosteroids as the most effective anti-inflammatory therapy available [1][2][3][4]. However, inhaled corticosteroids are not entirely devoid of risk and their use in clinical practice entails a judgement that weighs the potential benefits against the risks of treatment [5][6]. The potential for systemic effects of inhaled corticosteroids is considered to be reflected in their activity of suppressing the hypothalamic-pituitary-adrenal (HPA) axis [7]. However, the clinical relevance of such suppression has been questioned [8] and concerns have been raised concerning the possible effects of inhaled corticosteroids on bones [9] and growth [10]. This review examines the effects of inhaled corticosteroids on bone metabolism, bone density and growth in adults and children with asthma, in view of the recent availability of a substantial amount of new information from clinical trials. Effect of corticosteroids on bone metabolismCorticosteroids may lead to a reduction in bone mass and osteopenia via several different mechanisms, including direct effects on bone formation and bone resorption and indirect effects via actions on the pituitary-gonadal and pituitary-adrenal axes, intestinal calcium absorption, renal tubular calcium reabsorption and secondary hyperparathyroidism ( fig. 1) [11]. A number of biochemical markers have been used to assess the short-term effects of inhaled corticosteroids on bone turnover [12] (table 1). Bone formation has been evaluated by measuring blood concentrations of bone-specific alkaline phosphatase, osteocalcin and procollagen type-1 carboxy-terminal and amino-terminal propeptides (P1CP and P1NP, respectively). Bone resorption has been evaluated by measuring urinary excretion of hydroxyproline, calcium and pyridinium cross-links and by serum levels of type-1 carboxy-terminal telopeptide (1CTP) and tartrate-resistant acid phosphatase. Examination of relevant retrospective and prospective data, involving 11 studies (1,240 patients) on biochemical bone markers and 14 studies (373 patients) on bone density over a wide dose range, have largely indicated no significant or clinically important effect on these measurements in adults or children with asthma. Markers of bone formation and resorption need to be measured concurrently for a reliable assessment of bone turnover to be made.Knemometry, measuring lower leg growth rate, is a sensitive technique for comparing the systemic activity of different inhaled corticosteroids, but does not relate to long-term growth. The majority of approximately 40 studies on inhaled corticosteroids and statural growth in children, over a wide recommended dose range, including a number of recent long-term, prospective studies, demonstrate little or no effect. Children taking above recommended doses of inhaled corticosteroids should have their growth monitored using stadiometry at least every 6 month...

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“…Regarding the severity of the disease, most studies show an association or a trend towards growth decrease in children with severe asthma. Falliers et al (28) and Dawson et al (26) observed that children with severe asthma had weight and height below normal. McNicol et al (20) followed up 276 patients and 94 controls in a longitudinal study on asthmatic children from Australia, and noted a trend towards a weight decrease in the group with severer asthma.…”

Section: Influence Of Asthma On Growthmentioning

confidence: 97%

“…From 1949, when the use of cortisone was first described in the treatment of rheumatoid arthritis, up to the 1970s, cortisone products were widely used, although its many side effects were already known, including its effect on the growth of children with asthma (28,34,35) . Since 1970, the inhaled corticosteroids have redefined the development of the disease, for they are both potent drugs and have fewer side effects (36,37) .…”

Section: Inhaled Corticosteroids and Growthmentioning

confidence: 99%

“…Some works suggest that the use of low doses of inhaled corticosteroids, as well as of oral corticosteroids given on alternate days, might minimize a possible negative effect on growth (22,28,59) . Several authors who evaluated asthma patients of different age groups, using different inhaled corticosteroids, and various ways of administration, did not observe a negative impact of these drugs on growth (23,(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74) .…”

Section: Inhaled Corticosteroids and Growthmentioning

confidence: 99%

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Linear growth in asthmatic children

et al. 2003

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Asthma is the most frequent chronic inflammatory disease in childhood, and its prevalence has increased remarkably over the last decades. Therefore, the scientific community became interested in studying the growth of the affected children. The relationship between asthma and growth suffers the influence of the clinical picture, of therapeutics, but the different study methods make it difficult to distinguish the factors responsible for the growth retardation detected by some authors. This review has the purpose of providing an overall outlook on this matter. (J Pneumol 2003;29(1):36-42)

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Childhood Asthma and Steroid Therapy as Influences on Growth

Cited by 61 publications

References 20 publications

Plasma growth hormone concentration in corticosteroid-treated children

Plasma growth hormone concentration in corticosteroid-treated children

Effect of inhaled corticosteroids on bones and growth

Linear growth in asthmatic children

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