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:10.1002/14651858.cd009878.pub2

Cited by 79 publications

(47 citation statements)

References 102 publications

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“…In addition, they emphasize the importance of including GR monitoring in future studies and reinforce the recommendation of lower IC doses in children following disease control and during their maintenance treatment. 2 The absence of an association between GR impairment and IC in our study can be explained by the short interval between the two evaluations. Similar results were previously described by Singh et al in preschoolers.…”

Section: Discussioncontrasting

confidence: 54%

“…Its use is associated with fewer hospitalizations and care in emergency services, better quality of life and improved lung function. 2 The goal of treatment is control of the disease and remission of exacerbations with the lowest possible doses. 1 Systemic adverse events are described with varying intensity and dependent on the drug, dose and time of use, including: loss of bone mass, inhibition of the hypothalamic pituitary adrenal axis and growth deficit (with no change in growth cartilage).…”

mentioning

confidence: 99%

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Growth velocity and weight gain in prepubertal asthmatic children

Renosto

Acatauassu

Andrade

et al. 2017

Rev. Assoc. Med. Bras.

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Summary Objective: To evaluate the stature growth rate (GR) and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR) was calculated. Results: Excess weight (risk for overweight, overweight and obesity) was observed in 31.8% (27/85) of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2) was found in 13.9% (11/79) of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047). Use of steroids (dose, type and time of use) was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.

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Section: Discussioncontrasting

confidence: 54%

mentioning

confidence: 99%

Growth velocity and weight gain in prepubertal asthmatic children

Renosto

Acatauassu

Andrade

et al. 2017

Rev. Assoc. Med. Bras.

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“…A Cochrane meta-analysis found dose-response effects of ICS on growth. 42 Consequently, children on ICS should have regular monitoring of growth, and health care providers should titrate ICS dosing to the lowest dose that is effective.…”

Section: Figurementioning

confidence: 99%

Preventing Exacerbations in Preschoolers With Recurrent Wheeze: A Meta-analysis

et al. 2016

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CONTEXT: Half of children experience wheezing by age 6 years, and optimal strategies for preventing severe exacerbations are not well defined.OBJECTIVE: Synthesize the evidence of the effects of daily inhaled corticosteroids (ICS), intermittent ICS, and montelukast in preventing severe exacerbations among preschool children with recurrent wheeze. LIMITATIONS: More studies are needed that directly compare these strategies. CONCLUSIONS:There is strong evidence to support daily ICS for preventing exacerbations in preschool children with recurrent wheeze, specifically in children with persistent asthma. For preschool children with intermittent asthma or viral-triggered wheezing, there is strong evidence to support intermittent ICS for preventing exacerbations.

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“…ICS demonstrate a dose-response relationship for both efficacy and safety (as determined by growth velocity); however, most of the benefit is gained with low-to-moderate ICS dose, with minimal benefit in further increasing the dose (8,9). The approach of increasing the dose of ICS from low to moderate is often more practical than adding either LABA or LRTA because the inhaler has already been purchased.…”

Section: Expert Commentarymentioning

confidence: 99%