Inhaled corticosteroids in children with persistent asthma: dose‐response effects on growth

Pruteanu, Aniela I.; Chauhan, Bhupendrasinh F; Zhang, Linjie; Prietsch, Sílvio O. M.; Ducharme, Francine M

doi:10.1002/ebch.1989

Cited by 46 publications

(37 citation statements)

References 97 publications

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“…Although linear growth could not be measured in our study, recent RCTs found that daily use of beclomethasone is associated with a decreased linear growth of approximately 1 cm compared with the use of intermittent ICS or leukotriene receptor antagonist; a similar pattern has been found with regular use of other ICS. [40][41][42][43] An important limitation of observational studies is the possibility of unrecognized confounders. Although the matching process is designed to reduce this possibility by comparing cohorts of similar baseline asthma severity, we note that for the initiation population in analysis 1, there were fewer children with rhinitis, a factor that can influence asthma control, in the smallparticle cohort than in the standard sizeeparticle ICS cohort.…”

Section: Discussionmentioning

confidence: 99%

Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

Aalderen

Grigg

Guilbert

et al. 2015

The Journal of Allergy and Clinical Immunology: In Practice

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Section: Discussionmentioning

confidence: 99%

Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

Aalderen

Grigg

Guilbert

et al. 2015

The Journal of Allergy and Clinical Immunology: In Practice

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“…14 Indeed, many young children have asymptomatic periods between respiratory viral illnesses, 15 raising the question whether daily therapy with ICS is warranted in all children since ICS administration does not significantly alter the long-term disease course 16 and may contribute to dose-dependent and sustained reductions in linear growth in selected subpopulations. 17,18 …”

Section: Introductionmentioning

confidence: 99%

Individualized therapy for persistent asthma in young children

Fitzpatrick

Jackson

Mauger

et al. 2016

Journal of Allergy and Clinical Immunology

215

211

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Background Phenotypic presentations in young children with asthma are varied and may contribute to differential responses to asthma controller medications. Methods The Individualized Therapy for Asthma in Toddlers (INFANT) study was a multicenter, randomized, double-blind, double-dummy, clinical trial in children age 12-59 months (n=300) with asthma necessitating treatment with daily controller (Step 2) therapy. Participants completed a 2-8 week run-in period followed by three crossover periods with daily inhaled corticosteroid (ICS), daily leukotriene receptor antagonist (LTRA), and as-needed ICS treatment co-administered with albuterol. The primary outcome was differential response to asthma medication based on a composite measure of asthma control. The primary analysis involved two stages: determination of differential response, and assessment of whether three pre-specified features (aeroallergen sensitization, previous exacerbations, sex) predicted differential response. Results 74% (170 of 230) of children with analyzable data had a differential response to the three treatment strategies. Within differential responders, the probability of best response was highest for daily ICS and was predicted by aeroallergen sensitization, but not exacerbation history or sex. The probability of best response to daily ICS was further increased in children with both aeroallergen sensitization and blood eosinophils ≥300/μL. In these children, daily ICS was associated with more asthma control days and fewer exacerbations compared to the other treatments. Conclusions In young children with asthma necessitating Step 2 treatment, phenotyping with aeroallergen sensitization and blood eosinophils is useful for guiding treatment selection and identifies children with a high exacerbation probability for whom treatment with daily ICS is beneficial despite possible risks of growth suppression.

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“…Treatment with a low to moderate dose (200 µg HFA beclomethasone equivalent) was associated with a reduction in the growth rate by 0.20 cm/year (95% CI 0.02–0.39) after 12–52 weeks of treatment compared with those treated with a low dose (50–100 µg HFA beclomethasone equivalent; (166). …”

Section: Indicator 8: Height and Weightmentioning

confidence: 99%

The Danish National Database for Asthma: establishing clinical quality indicators

Hansen

Hoffmann-Petersen

Sverrild

et al. 2016

European Clinical Respiratory Journal

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Asthma is one of the most common chronic diseases worldwide affecting more than 300 million people. Symptoms are often non-specific and include coughing, wheezing, chest tightness, and shortness of breath. Asthma may be highly variable within the same individual over time. Although asthma results in death only in extreme cases, the disease is associated with significant morbidity, reduced quality of life, increased absenteeism, and large costs for society. Asthma can be diagnosed based on report of characteristic symptoms and/or the use of several different diagnostic tests. However, there is currently no gold standard for making a diagnosis, and some degree of misclassification and inter-observer variation can be expected. This may lead to local and regional differences in the treatment, monitoring, and follow-up of the patients. The Danish National Database for Asthma (DNDA) is slated to be established with the overall aim of collecting data on all patients treated for asthma in Denmark and systematically monitoring the treatment quality and disease management in both primary and secondary care facilities across the country. The DNDA links information from population-based disease registers in Denmark, including the National Patient Register, the National Prescription Registry, and the National Health Insurance Services register, and potentially includes all asthma patients in Denmark. The following quality indicators have been selected to monitor trends: first, conduction of annual asthma control visits, appropriate pharmacological treatment, measurement of lung function, and asthma challenge testing; second, tools used for diagnosis in new cases; and third, annual assessment of smoking status, height, and weight measurements, and the proportion of patients with acute hospital treatment. The DNDA will be launched in 2016 and will initially include patients treated in secondary care facilities in Denmark. In the nearby future, the database aims to include asthma diagnosis codes and clinical data registered by general practitioners and specialised practitioners as well.

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Inhaled corticosteroids in children with persistent asthma: dose‐response effects on growth

Cited by 46 publications

References 97 publications

Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

Individualized therapy for persistent asthma in young children

The Danish National Database for Asthma: establishing clinical quality indicators

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