Assessment of the long-term safety of inhaled ciclesonide on growth in children with asthma.
OBJECTIVE
To assess the effects of the new inhaled corticosteroid ciclesonide on growth in children with asthma.


METHODS
We performed a multicenter, randomized, double-blind, placebo-controlled study to assess the effects of inhaled ciclesonide on growth in children with mild, persistent asthma. After a 6-month run-in period, 661 prepubertal children who were aged 5.0 to 8.5 years were randomly assigned to once-daily morning treatment for 1 year with ciclesonide 40 or 160 microg (ex-actuator) or placebo, followed by a 2-month follow-up period. The primary end point was the linear growth velocity (linear regression estimate) over the double-blind treatment period. Growth was recorded as the median of 4 stadiometer measurements. Adverse events and 10-hour overnight and 24-hour urinary free cortisol levels were also assessed.


RESULTS
Mean linear growth velocity during run-in was comparable between groups: 160 microg, 6.20 cm/year; 40 microg, 6.59 cm/year; placebo, 6.49 cm/year. Mean differences from placebo (5.75 cm/year) in growth velocity over the double-blind treatment period were -0.02 cm/year for ciclesonide 40 microg and -0.15 cm/year for ciclesonide 160 microg. Both ciclesonide treatments were noninferior to placebo with respect to growth velocity. The overall incidence of adverse events was comparable between groups, and no significant changes in 10-hour overnight or 24-hour urinary free cortisol levels were noted between groups during the double-blind treatment period.


CONCLUSIONS
Ciclesonide demonstrated no detectable effect on childhood growth velocity, even at the highest dosage, which may ease concerns about systemic adverse events.
Skoner
David P
DP
Allegheny General Hospital, Department of Pediatrics, 320 E North Ave, South Tower, Seventh Floor, Pittsburgh, PA 15212, USA. dskoner@wpahs.org
Maspero
Jorge
J
Banerji
Donald
D
D000280:Administration, Inhalation; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002657:Child Development / Q000187:drug effects; D002675:Child, Preschool; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006128:Growth / Q000187:drug effects*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011282:Pregnenediones / Q000008:administration & dosage* / Q000009:adverse effects; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D013147:Spirometry; D016896:Treatment Outcome
D011282:Pregnenediones; C120481:ciclesonide