A comparison of the relative growth velocities with budesonide and fluticasone propionate in children with asthma.
There have been no previous large, well-designed direct comparisons of the effects of fluticasone propionate (FP) and budesonide (BUD) on growth in children. This randomised, double-blind study compared the effects on growth of FP and BUD in children aged 6-9 years with persistent asthma. Following a 6-month run-in period (without inhaled corticosteroids), patients with normal growth velocity were randomised to 12 months' treatment with FP 100 micro g bd (n=114) or BUD 200 micro g bd (n=119). Growth velocity was determined by stadiometric height measurement. Lung function, asthma symptoms and use of relief medication were also assessed. Annualised mean growth velocity during run-in was comparable in the two groups (FP: 5.9 cm/yr; BUD: 6.0 cm/yr). During the treatment period, adjusted mean growth velocity was significantly higher in the FP than the BUD group (5.5 cm/yr vs 4.6 cm/yr; P<0.001). Asthma control improved similarly in both treatment groups. Bone mineral density and overnight urinary cortisol:creatinine ratios were similar in the two groups. Drug-related adverse events were reported among 3% of FP-treated children, compared with 2% for BUD. In conclusion, this study demonstrates that FP for childhood asthma has significantly less impact on childhood growth velocity than a therapeutically equivalent dose of BUD.
Ferguson
Alexander C
AC
Division of Allergy, University of British Columbia, BC's Children's Hospital, Vancouver, BC, Canada. aferguson@cw.bc.ca
Van Bever
Hugo P
HP
Teper
Alejandro M
AM
Lasytsya
Olga
O
Goldfrad
Caroline H
CH
Whitehead
Philip J
PJ
D000730:Androstadienes / Q000009:adverse effects* / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D019819:Budesonide / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D004311:Double-Blind Method; D005260:Female; D000068298:Fluticasone; D006128:Growth / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D008297:Male; D012044:Regression Analysis; D016896:Treatment Outcome
D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D019819:Budesonide; D000068298:Fluticasone; D006854:Hydrocortisone