title: Growth of preschool children at high risk for asthma 2 years after discontinuation of fluticasone.
abstract: 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).
  
  
  CONCLUSIONS
  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.affiliation: Department of Pediatrics, University of Wisconsin-Madison, Wis 53716, USA. tguilbert@wisc.edu
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Guilbert
authors.forename: David T
authors.initials: DT
authors.lastname: Mauger
authors.forename: David B
authors.initials: DB
authors.lastname: Allen
authors.forename: Robert S
authors.initials: RS
authors.lastname: Zeiger
authors.forename: Robert F
authors.initials: RF
authors.lastname: Lemanske
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Szefler
authors.forename: Robert C
authors.initials: RC
authors.lastname: Strunk
authors.forename: Leonard B
authors.initials: LB
authors.lastname: Bacharier
authors.forename: Ronina
authors.initials: R
authors.lastname: Covar
authors.forename: Christine A
authors.initials: CA
authors.lastname: Sorkness
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Taussig
authors.forename: Fernando D
authors.initials: FD
authors.lastname: Martinez
mesh_terms: D000367:Age Factors; D000730:Androstadienes / Q000009:adverse effects* / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000517:prevention & control*; D001827:Body Height / Q000187:drug effects*; D001835:Body Weight / Q000502:physiology; D002675:Child, Preschool; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D012135:Respiratory Sounds
chemical_list: D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D000068298:Fluticasone