Inhaled corticosteroids in children with persistent asthma: is there a dose response impact on growth? - an overview of Cochrane reviews

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

doi:10.1016/j.prrv.2014.10.002

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…We emphasize the importance and necessity of future studies with longer observation intervals. 21 Another concern is the persistence of reduction in the adult's final height due to the use of IC as a child. A study that included 173,034 Swedish military recruits aged 18 years (8,531 asthmatics) showed a discrete but significant difference in height between asthmatics and normal controls, with a negative correlation between height and asthma severity.…”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…Therefore this research will add to current knowledge: a) improvements in the appropriateness of prescriptions; b) the acquisition of epidemiological reference data with the fewest possible error (<5%); c) a reduction in bias enrollment and Protocol drop-outs; d) a reduction in the number of respiratory drug prescriptions compared to historical data (data of prescriptions in previous years); e) a reduction in public spending, through prescriptions and inappropriate hospital admittances; f) a correct valuation, in question, of ADRs related to pharmaceuticals administered and in particular of the effect of IS on growth [14][15][16][17][18][19][20]; g) an increase in reports of ADRs after Family Pediatricians training.…”

Section: Introductionmentioning

confidence: 99%

REDS (Respiratory Drugs Survey) Study. Active Surveillance of Respiratory Drugs and in Particular of Inhaled Steroids (IS) in the Paediatric Age

Napoleone¹,

Lavalle

Scasserra³

et al. 2018

Int. J. Pediatr. Child Health

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Background and aims: Inhaled Steroids (IS) are used inappropriately for children who have been "over prescribed" for conditions such as colds, coughs and sore throats. This practice is not always based on scientific evidence. IS have a modest effectiveness in preventing both recurrent wheezing, viral and bronchiolitis in children. The aim of the study is to monitor the use of IS with careful analysis of the risk / benefit factor of the treatment, through accuracy of diagnosis, the therapeutic appropriateness and the safe use of these medications. Methods: In this epidemiological / observational (case-study) and active observational project, the prescribing data for children (0-14 yrs) were collected and processed by Family Pediatricians (FPs). The activities have been divided into four sections: 1) Elaboration of the prescriptive data (year 2015-retrospective) 2) Training / information events for FPs and families on the correct use of IS (year 2016) 3) Elaboration of the prescriptive data of the same FPs after the training year (year 2017-prospective) 4) Comparison of the prescriptive data of IS in the age group of 0 - 14 years in the years 2015 and 2017 (before and after the training phase) Results: After the training phase: the prevalence of use of IS decreased from 20.71% to 15.15% ; the percentage of the appropriate prescriptions increased from 30.65% to 58.02% ; the percentage of the inappropriate prescriptions decreased from 68.67 % to 38.66%; the prevalence of inappropriate prescriptions decreased : a) in the 0-4 yrs from 70.24% to 39.30%; b) in the 5-10 yrs from 66.31% to 35.95%, and c) in the 11-14 yrs from 69.80% to 35.04%; the percentage of inappropriate expenditure decreased from 67.31% to 37.63%; the percentages of inappropriate prescriptions decreased for Beclomethasone from 71.47% to 38.29%, for Budesonide from 69.82% to 43.29%, for Fluticasone from 53.84% to 19.01% and for Flunisolide from 70.45% to 56.93% ; the total number of pieces prescribed decreased from 4.338 to 3.148. Conclusions: We have highlighted that through training courses for Family Pediatricians and a correct information to families a significant improvement in the use of Inhaled Steroids can be achieved.

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Selective Nonsteroidal Glucocorticoid Receptor Modulators for the Inhaled Treatment of Pulmonary Diseases

et al. 2017

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A class of potent, nonsteroidal, selective indazole ether-based glucocorticoid receptor modulators (SGRMs) was developed for the inhaled treatment of respiratory diseases. Starting from an orally available compound with demonstrated anti-inflammatory activity in rat, a soft-drug strategy was implemented to ensure rapid elimination of drug candidates to minimize systemic GR activation. The first clinical candidate 1b (AZD5423) displayed a potent inhibition of lung edema in a rat model of allergic airway inflammation following dry powder inhalation combined with a moderate systemic GR-effect, assessed as thymic involution. Further optimization of inhaled drug properties provided a second, equally potent, candidate, 15m (AZD7594), that demonstrated an improved therapeutic ratio over the benchmark inhaled corticosteroid 3 (fluticasone propionate) and prolonged the inhibition of lung edema, indicating potential for once-daily treatment.

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Inhaled corticosteroids in children with persistent asthma: is there a dose response impact on growth? - an overview of Cochrane reviews

Cited by 5 publications

References 4 publications

Growth velocity and weight gain in prepubertal asthmatic children

Growth velocity and weight gain in prepubertal asthmatic children

REDS (Respiratory Drugs Survey) Study. Active Surveillance of Respiratory Drugs and in Particular of Inhaled Steroids (IS) in the Paediatric Age

Selective Nonsteroidal Glucocorticoid Receptor Modulators for the Inhaled Treatment of Pulmonary Diseases

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