Side-effects of fluticasone in asthmatic children: no effects after dose reduction

MJ Visser*, E van der Veer, DS Postma, LR Arends, TW de Vries, PLP Brand, EJ Duiverman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

46 Citations (Scopus)

Abstract

To assess long-term effects and side-effects of fluticasone propionate (FP), a 2-yr study was performed, comparing a step-down dose approach (1,000 mug.day(-1), with reductions every 2 months to 500, 200 and 100 mug.day(-1) for the remainder of the study) versus a constant dose (200 mug.day(-1)).

In 55 children with chronic persistent asthma, aged 6-10 yrs, airways hyperresponsiveness (AHR) and systemic side-effects (height, bone parameters and adrenal cortical function) were assessed at predetermined intervals in a double-blind prospective 2-yr study.

AHR improved after 4 months treatment with 1,000 mug.day(-1) FP followed by 500 mug.day(-1) without significant differences during long-term treatment between the two approaches. Dose-dependent reduction of growth velocity, adrenal cortical function and biochemical bone turnover was found during therapy with 1,000 and 500 mug.day(-1) FP when compared with 200 mug.day(-1).

In conclusion, doses of 1,000 and 500 mug.day(-1) fluticasone propionate are associated with marked reductions of growth velocity, bone turnover and adrenal cortical function. However, conventional doses (less than or equal to200 mug.day(-1) fluticasone propionate) appear to be safe in the long-term management of childhood asthma. From a safety point of view, high doses of fluticasone propionate should only be prescribed in exceptions, e.g. in persistent severe asthma.

Original languageEnglish
Pages (from-to)420-425
Number of pages6
JournalEuropean Respiratory Journal
Volume24
Issue number3
Publication statusPublished - Sep-2004

Keywords

  • adrenal cortex
  • bone metabolism
  • fluticasone
  • height
  • hyperresponsiveness
  • BONE-MINERAL DENSITY
  • LONG-TERM TREATMENT
  • INHALED CORTICOSTEROIDS
  • ADRENAL SUPPRESSION
  • CHILDHOOD ASTHMA
  • GROWTH
  • PROPIONATE
  • BUDESONIDE
  • TURNOVER
  • STEROIDS

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