TY - JOUR
T1 - Growth of preschool children at high risk for asthma 2 years after discontinuation of fluticasone
AU - Guilbert, Theresa W.
AU - Mauger, David T.
AU - Allen, David B.
AU - Zeiger, Robert S.
AU - Lemanske, Robert F.
AU - Szefler, Stanley J.
AU - Strunk, Robert C.
AU - Bacharier, Leonard B.
AU - Covar, Ronina
AU - Sorkness, Christine A.
AU - Taussig, Lynn M.
AU - Martinez, Fernando D.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2011/11
Y1 - 2011/11
N2 - Background: The effect on linear growth of daily long-term inhaled corticosteroid therapy in preschool-aged children with recurrent wheezing is controversial. Objective: We sought to determine the effect of daily inhaled corticosteroid given for 2 years on linear growth in preschool children with recurrent wheezing. Methods: Children aged 2 and 3 years with recurrent wheezing and positive modified Asthma Predictive Index scores were randomized to a 2-year treatment period of chlorofluorocarbon-delivered fluticasone propionate (176 μg/d) or masked placebo delivered through a valved chamber with a mask and then followed for 2 years off study medication. Height growth determined by means of stadiometry was compared between treatment groups. Results: In the study cohort as a whole, the fluticasone group did not have significantly less linear growth than the placebo group (change in height from baseline difference, -0.2 cm; 95% CI, -1.1 to 0.6) 2 years after discontinuation of study treatment. In post hoc analyses children 2 years old who weighed less than 15 kg at enrollment and were treated with fluticasone had less linear growth compared with those treated with placebo (change in height from baseline difference, -1.6 cm; 95% CI, -2.8 to -0.4; P =.009). Conclusion: Linear growth was not significantly different in high-risk preschool-aged children with recurrent wheezing treated with 176 μg/d chlorofluorocarbon-delivered fluticasone compared with placebo 2 years after fluticasone is discontinued. However, post hoc subgroup analyses revealed that children who are younger in age and of lesser weight relative to the entire study cohort had significantly less linear growth, possibly because of a higher relative fluticasone exposure.
AB - Background: The effect on linear growth of daily long-term inhaled corticosteroid therapy in preschool-aged children with recurrent wheezing is controversial. Objective: We sought to determine the effect of daily inhaled corticosteroid given for 2 years on linear growth in preschool children with recurrent wheezing. Methods: Children aged 2 and 3 years with recurrent wheezing and positive modified Asthma Predictive Index scores were randomized to a 2-year treatment period of chlorofluorocarbon-delivered fluticasone propionate (176 μg/d) or masked placebo delivered through a valved chamber with a mask and then followed for 2 years off study medication. Height growth determined by means of stadiometry was compared between treatment groups. Results: In the study cohort as a whole, the fluticasone group did not have significantly less linear growth than the placebo group (change in height from baseline difference, -0.2 cm; 95% CI, -1.1 to 0.6) 2 years after discontinuation of study treatment. In post hoc analyses children 2 years old who weighed less than 15 kg at enrollment and were treated with fluticasone had less linear growth compared with those treated with placebo (change in height from baseline difference, -1.6 cm; 95% CI, -2.8 to -0.4; P =.009). Conclusion: Linear growth was not significantly different in high-risk preschool-aged children with recurrent wheezing treated with 176 μg/d chlorofluorocarbon-delivered fluticasone compared with placebo 2 years after fluticasone is discontinued. However, post hoc subgroup analyses revealed that children who are younger in age and of lesser weight relative to the entire study cohort had significantly less linear growth, possibly because of a higher relative fluticasone exposure.
KW - Asthma Predictive Index
KW - atopy
KW - clinical trials
KW - early childhood asthma
KW - fluticasone
KW - inhaled corticosteroids
KW - intermittent wheezing
KW - linear growth
KW - research network
UR - http://www.scopus.com/inward/record.url?scp=80055085153&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2011.06.027
DO - 10.1016/j.jaci.2011.06.027
M3 - Article
C2 - 21820163
AN - SCOPUS:80055085153
VL - 128
SP - 956-963.e7
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
SN - 0091-6749
IS - 5
ER -