Document Detail


Growth of preschool children at high risk for asthma 2 years after discontinuation of fluticasone.
MedLine Citation:
PMID:  21820163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Theresa W Guilbert; David T Mauger; David B Allen; Robert S Zeiger; Robert F Lemanske; Stanley J Szefler; Robert C Strunk; Leonard B Bacharier; Ronina Covar; Christine A Sorkness; Lynn M Taussig; Fernando D Martinez;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-08-04
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  128     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-31     Completed Date:  2011-12-12     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  956-63.e1-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Androstadienes / adverse effects*,  therapeutic use
Anti-Asthmatic Agents / adverse effects*,  therapeutic use
Asthma / prevention & control*
Body Height / drug effects*
Body Weight / physiology
Child, Preschool
Cohort Studies
Double-Blind Method
Female
Humans
Male
Respiratory Sounds*
Grant Support
ID/Acronym/Agency:
1 UL1 RR025780/RR/NCRR NIH HHS; 5U10HL064287/HL/NHLBI NIH HHS; 5U10HL064288/HL/NHLBI NIH HHS; 5U10HL064295/HL/NHLBI NIH HHS; 5U10HL064305/HL/NHLBI NIH HHS; 5U10HL064307/HL/NHLBI NIH HHS; 5U10HL064313/HL/NHLBI NIH HHS; HL004519-04/HL/NHLBI NIH HHS; HL071742/HL/NHLBI NIH HHS; K08 HL071742-05/HL/NHLBI NIH HHS; K08 HL071742-06/HL/NHLBI NIH HHS; K30 HL004519-01/HL/NHLBI NIH HHS; M01 RR000036-44/RR/NCRR NIH HHS; M01 RR00036/RR/NCRR NIH HHS; U10 HL064288/HL/NHLBI NIH HHS; U10 HL064288-01/HL/NHLBI NIH HHS; U10 HL064288-06/HL/NHLBI NIH HHS; U10 HL064295-06/HL/NHLBI NIH HHS; U10 HL064305/HL/NHLBI NIH HHS; U10 HL064305-06/HL/NHLBI NIH HHS; U10 HL064307-06/HL/NHLBI NIH HHS; U10 HL064313/HL/NHLBI NIH HHS; U10 HL064313-05/HL/NHLBI NIH HHS; UL1 RR025780/RR/NCRR NIH HHS; UL1 RR025780-03/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Androstadienes; 0/Anti-Asthmatic Agents; CUT2W21N7U/fluticasone
Investigator
Investigator/Affiliation:
Gregory Heldt / ; Michael H Mellon / ; Noah J Friedman / ; Alfredo A Jalowayski / ; Michael Schatz / ; Sandra C Christiansen / ; Kathleen Harden / ; Catherine Nelle / ; Eva Rodriguez / ; Linda Galbreath / ; Elaine Jensen / ; Robert C Strunk / ; Leonard B Bacharier / ; Gordon R Bloomberg / ; James M Corry / ; Tina Oliver-Welker / ; Valerie Morgan / ; Kevin Hodgdon / ; Wanda Caldwell / ; Cindy Moseid / ; Fernando D Martinez / ; Wayne Morgan / ; Theresa W Guilbert / ; John D Mark / ; Mark Brown / ; James Goodwin / ; Melisa Celaya / ; Anna Valencia / ; Janet Lawless / ; Rosemary Weese / ; Shelley Radford / ; William Hall / ; Lynn M Taussig / ; James Kiley / ; Virginia Taggart / ; Gail Weinmann / ; Gang Zheng / ; Vernon M Chinchilli / ; David Mauger / ; Ian Paul / ; Susan Boehmer / ; Loretta Doty / ; Jill Kuennen / ; Jill Hofsass / ; Sherrie Whisler / ; Linda Ferrari / ; Pamela Arminavage / ; Liza Brandt / ; Cathy Goeckel / ; Jim Schmidt / ; Brenda Beers / ; Linda Miller / ; Judy Potteiger / ; Lori Schell / ; Venus Mintz-Grella / ; Liza Say / ; Margaret Sheely / ; Trina Armstrong / ; Holly Hess / ; Victor Sanchez / ; Vanessa Simmons / ; Thomas F Boat / ; William C Bailey / ; Mary Kay Garcia / ; Carolyn M Kercsmar / ; H William Kelly / ; Lester Lyndon Key / ; James Tonascia / ; Benjamin Wilfond / ; Philip Ballard / ; Clarence E Davis / ; Diane E McLean / ; Gail Shapiro / ; Paul O'Byrne / ; Mark Liu / ; Lynn M Taussig / ; Virginia S Taggart / ; Stanley J Szefler / ; Robert F Lemanske / ; Robert S Zeiger / ; Robert C Strunk / ; Fernando D Martinez / ; Vernon M Chinchilli / ; Robert F Lemanske / ; Stanley J Szefler / ; Fernando D Martinez / ; Robert S Zeiger / ; Vernon M Chinchilli / ; Robert C Strunk / ; Theresa W Guilbert / ; Dave T Mauger / ; Timothy J Craig / ; Susan Boehmer / ; Jill T Kuennen / ; James Goodwin / ; James R Schmidt / ; Wayne Morgan / ; Gregory Heldt / ; Gary Larsen / ; Christine A Sorkness / ; Joseph D Spahn / ; Kevin Hodgdon / ; Rick Kelley / ; Shelley Radford / ; Eva Rodriguez / ; Loretta Doty / ; Richard Evans / ; Jason Lennon / ; Lori Sanders / ; Jeff Davis / ; Fernando D Martinez / ; Stanley J Szefler / ; Robert F Lemanske / ; Vernon M Chinchilli / ; David T Mauger / ; Brenda Phillips / ; Pharmaceutical Muro /
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