Short-term Growth and Bone Turnover in Children with Persistent Asthma During. inhaled Steroid Therapy

Abstract

Bronchial asthma has been recently regarded as a chronic intlarnmatory disease of the airways. which reflects the importance of anti-inflammatory therapy for long-tenn prophylactic treatment m persistent asthma. Cotticosteroids remain the most potent anti-inflan11natmy therapy available. Inhaled corticosteroids have far fewer adverse effects than their oral cow1terpa.ts; however, their risks must be carefully considered, especially regarding bone metabolism and growt h suppression in children. 1l1e aim of the present study was to com pare the formation and degradation markers of bone turnover in children with asthma who are using inhaled fluticasone propionate (FP), as well as to study the effect of inhaled FP on short tenn statural growth. and the degree of improvement in pulmona.y fw1ctions. 1l1e present study included 34 asthmatic children (b'TOUp 1), 18 males and 16 females, of the age group 6-12 years, who were on regul ar follow up in the Pediatric Asthma and Allerb'Y Out-patien t Clinic of Chi ldren 's Hospital, Cairo U niversi ty. 1l1is group was further subdiv ided into hvo groups:. a) Group Ia: receiving fluticasone propionate (FP), via metered dose inhalers (MDI), at dosages equal to or below 200 meg/day ( 19 patients), and b) Group lb: receiving FP at doses above 200 meg/day (15 patients). The study also included 14 healthy, non-atopic, non-asthmatic children (group II) as controls. They were 8 males and 6 females of the same age group. All asthmatic children were subjected to: full medical history, symptom

score calculation, complete clinical examination. assessment of height, weight and BMl calculation, PEFR monitoring, as well as pulmonary function testing, before and after treatment, CBC with AEC calculation, urine and stool analyses, total senun lgE once, serum calcium, phosphorous. and alkaline