TY - JOUR
TI - The effect of inhaled budesonide on adrenal and growth suppression in
asthmatic children
AU - Priftis, KN
AU - Papadimitriou, A
AU - Gatsopoulou, E
AU - Yiallouros, PK
AU - and Fretzayas, A
AU - Nicolaidou, P
JO - European Respiratory Journal
PY - 2006
VL - 27
TODO - 2
SP - 316-320
PB - EUROPEAN RESPIRATORY SOC JOURNALS LTD
SN - 0903-1936, 1399-3003
TODO - 10.1183/09031936.06.00071905
TODO - adrenal function; asthma; children; growth; inhaled budesonide
TODO - The present authors evaluated adrenal reserve in asthmatic children on
long-term inhaled corticosteroids and whether possible adrenal
suppression could be predicted by growth retardation.
Low-dose synacthen test (0.5 mu g.1.73 m(-2)) was performed in 72
asthmatic children with a median age of 9.4 (range 4.2-15.7) yrs on
long-term treatment (median 18 (range 6-84) months) with low-to-moderate
doses (median 363 (range 127-1012) mu g.m(-2)) of inhaled budesonide, as
well as in 30 controls. Adrenal suppression was considered as a peak
serum cortisol <495 nmol.L-1. The current authors calculated height
standard deviation score (HSDS) at the time of testing and height
velocity SDS (HVSDS) in the preceding year.
Mean HSDS was 0.06+/-1.3 and HVSDS was -0.9+/-2.3. Adrenal suppression
was disclosed in 15 asthmatic children (20.8%). There were no
differences in HSDS and HVSDS between children with and without adrenal
suppression. There was no correlation between peak cortisol response and
dose or duration of treatment. However, a positive relationship between
HVSDS and duration of treatment was noted.
These data suggest that long-term treatment of asthmatic children with
low and moderate doses of inhaled budesonide may result in mild adrenal
suppression that cannot be predicted by growth deceleration. The
negative influence of inhaled corticosteroids on growth becomes less the
longer the duration of treatment.
ER -