title: Growth of prepubertal children with mild asthma treated with inhaled beclomethasone dipropionate.
abstract: Poorly controlled severe asthma can lead to growth impairment in childhood. In children with mild asthma, it is less clear whether treatment influences growth or adrenal function. We determined in a randomized, double-blind, placebo-controlled, community-based study, the effect of inhaled beclomethasone dipropionate (BDP) 400 micrograms/day for 7 mo on the linear growth and adrenal function of 94 children 7 to 9 yr of age. Height was measured at least monthly during treatment, and adrenal function assessed by overnight urinary cortisol at baseline and after 3 and 6 mo of treatment. Mean regressed daily growth was significantly decreased during the treatment period in the BDP-treated group, 0.79 versus 1.14 mm/wk (difference 0.35 mm/wk; 95% CI -0.46 to -0.25; p < 0.0001). At the end of the 7 mo, the BDP-treated children had grown significantly less than the children on placebo: mean of 2.66 versus 3.66 cm (difference 1.0 cm; 95% CI -1.36 to -0.64 cm; p < 0.0001). Growth was significantly decreased in both males and females. During a washout period of 4 mo, there was no significant catch-up growth. BDP had no effect on overnight urinary cortisol production. BDP at a dose taken by many children significantly decreases statural growth in children with mild asthma, and this effect is unlikely to be mediated through the hypothalamo-pituitary-adrenal axis.
authors.affiliation: Southampton General Hospital, United Kingdom.
authors.forename: I J
authors.initials: IJ
authors.lastname: Doull
authors.forename: N J
authors.initials: NJ
authors.lastname: Freezer
authors.forename: S T
authors.initials: ST
authors.lastname: Holgate
mesh_terms: D000280:Administration, Inhalation; D000311:Adrenal Glands / Q000187:drug effects / Q000502:physiology; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001507:Beclomethasone / Q000008:administration & dosage / Q000009:adverse effects*; D001827:Body Height; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006130:Growth Disorders / Q000139:chemically induced*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D008297:Male; D010913:Pituitary-Adrenal System / Q000187:drug effects
chemical_list: D001507:Beclomethasone; D006854:Hydrocortisone