To the editor: Clinical observations on catch-up growth in asthmatic children following withdrawal of inhaled glucocorticosteroids
✍ Scribed by Marja-Terttu Saha; Pekka Laippala; Hanna Liisa Lenko
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 33 KB
- Volume
- 26
- Category
- Article
- ISSN
- 8755-6863
No coin nor oath required. For personal study only.
✦ Synopsis
PRED. In other words, the effect of inhaled BUD on skeletal metabolism was significantly less than that of therapeutically equivalent doses of oral PRED, as has been suggested in previous reports on adults. 8,10 It is possible that the bioequivalent potency ratio of PRED:BUD, measured by its inhibition on OC production, might be higher in children than in adults. It appears that children can tolerate much higher doses of BUD than adults, with a sparing of systemic activity.
Previous reports have shown that inhaled BUD at 800 g/day for 2 weeks was not associated with a reduction of OC levels, 2 while the same dose for 1 month showed a reduction. 4 Our study noted that inhaled BUD м800 g/day for 2 weeks did affect OC levels to some extent. Based on our findings we speculate that a dose of 800 g/day of inhaled BUD for 2 weeks might be the maximum dose for children with asthma.
We conclude that inhaled BUD in doses up to 400 g/day does not seem to affect bone metabolism in children with asthma. Considering the risk of adverse effects on bone turnover, we suggest that children with asthma can take an inhaled dose of BUD of up to 800 g/day, and such a dose is preferable to oral PRED 2.5 mg/day during short-term treatment. Further studies are needed to determine whether and to what extent the changes in biochemical markers of bone turnover actually signify a clinically important risk for osteoporosis or bone growth after long-term use of inhaled corticosteroids. More sensitive markers, such as carboxypropeptide type I procollagen (PICP), together with other markers of bone resorption, 1 might provide additional information about net bone turnover in asthmatic children treated with inhaled corticosteroids.