European Journal of Pediatrics

, Volume 166, Issue 1, pp 23–28

Do inhaled corticosteroids impair long-term growth in prepubertal cystic fibrosis patients?

  • Kris De Boeck
  • Frans De Baets
  • Anne Malfroot
  • Kristine Desager
  • Françoise Mouchet
  • Marijke Proesmans
Original Paper

DOI: 10.1007/s00431-006-0198-9

Cite this article as:
De Boeck, K., De Baets, F., Malfroot, A. et al. Eur J Pediatr (2007) 166: 23. doi:10.1007/s00431-006-0198-9

Abstract

Despite absence of clear proof of efficacy, the use of inhaled corticosteroids (ICS) is widespread in cystic fibrosis (CF) patients. Therefore, the effect of ICS on lung function and other clinical variables was studied in 27 prepubertal CF children with mild to moderate lung disease. In a prospective double-blind case-controlled study, fluticasone propionate 500 μg or placebo were administered twice daily during 12 months. The mean (standard error of the mean, SEM) patient age was 8.2 (0.6) years in the placebo group and 9.0 (0.5) years in the fluticasone group. The mean (SEM) forced expiratory volume in 1 s (FEV1) was 91% (4%) in the placebo group and 86% (4%) in the fluticasone group. There was no statistically significant difference in the evolution of lung function and the number of respiratory exacerbations between groups. However, longitudinal growth in fluticasone patients was significantly slower than in placebo patients: 3.96 (0.29) cm versus 5.49 (0.38) cm [p<0.005, analysis of variance (ANOVA)] over the 12-month study duration. This resulted in a significant change in height standard deviation score (SDS) of –0.38 (0.09) in the fluticasone group versus –0.01 (0.07) in the placebo group (p<0.003, ANOVA). No catch-up growth was noted 1–2 years after discontinuation of inhaled steroids. The use of high-dose ICS in CF patients with mild lung disease may lead to persistent growth impairment.

Keywords

Inhaled corticosteroids Growth Cystic fibrosis Prepubertal Lung function 

Abbreviations

ICS

Inhaled corticosteroids

CF

Cystic fibrosis

FEV1

Forced expiratory volume in 1 s

IV

Intravenous

IgG

Immunoglobulin G

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Kris De Boeck
    • 1
  • Frans De Baets
    • 2
  • Anne Malfroot
    • 4
  • Kristine Desager
    • 3
  • Françoise Mouchet
    • 4
  • Marijke Proesmans
    • 1
  1. 1.Department of Pediatric Pulmonology and Cystic Fibrosis ClinicUniversity Hospital of LeuvenLeuvenBelgium
  2. 2.Pediatric Pulmonology and Cystic Fibrosis ClinicUniversity of GhentGhentBelgium
  3. 3.Pediatric Pulmonology and Cystic Fibrosis ClinicUniversity of AntwerpAntwerpBelgium
  4. 4.Pediatric Pulmonology and Cystic Fibrosis ClinicUniversity of BrusselsBrusselsBelgium

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