A comparison of the relative growth velocities with budesonide and fluticasone propionate in children with asthma

Ferguson, Alexander C.; Van Bever, Hugo P.; Teper, Alejandro M.; Lasytsya, Olga; Goldfrad, Caroline H.; Whitehead, Philip J.

doi:10.1016/j.rmed.2006.04.009

« Previous Next »Respiratory Medicine
Volume 101, Issue 1 , Pages 118-129, January 2007

A comparison of the relative growth velocities with budesonide and fluticasone propionate in children with asthma

Alexander C. Ferguson
- Division of Allergy, University of British Columbia, B.C.'s Children's Hospital, 4480 Oak Street, Vancouver, BC,Canada V6H 3V4
- Corresponding author. Department of Paediatrics, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada V6H 3V4. Tel.: 16048752118; fax: 16048753653.
Hugo P. Van Bever
- Department of Paediatrics, National University Hospital, 5 Lower Kent Ridge Road, 119074 Singapore, Singapore
Alejandro M. Teper
- Hospital Niños “Ricardo Gutierrez”, Gallo 1330, Buenos Aires, Argentina
Olga Lasytsya
- Kiev Medical Academy of Postgraduate Education, 9 Dorogozshitskaya St., Kiev-112, Ukraine
Caroline H. Goldfrad
- GlaxoSmithKline Research and Development Limited, Greenford Road, Greenford, Middlesex UB6 OHE, UK
Philip J. Whitehead
- GlaxoSmithKline Research and Development Limited, Greenford Road, Greenford, Middlesex UB6 OHE, UK

Received 26 September 2005; accepted 11 April 2006. published online 30 May 2006.

Summary

There have been no previous large, well-designed direct comparisons of the effects of fluticasone propionate (FP) and budesonide (BUD) on growth in children. This randomised, double-blind study compared the effects on growth of FP and BUD in children aged 6–9 years with persistent asthma.

Following a 6-month run-in period (without inhaled corticosteroids), patients with normal growth velocity were randomised to 12 months’ treatment with FP 100μg bd () or BUD 200μgbd (). Growth velocity was determined by stadiometric height measurement. Lung function, asthma symptoms and use of relief medication were also assessed.

Annualised mean growth velocity during run-in was comparable in the two groups (FP: 5.9cm/yr; BUD: 6.0cm/yr). During the treatment period, adjusted mean growth velocity was significantly higher in the FP than the BUD group (5.5cm/yr vs 4.6cm/yr; ). Asthma control improved similarly in both treatment groups. Bone mineral density and overnight urinary cortisol:creatinine ratios were similar in the two groups. Drug-related adverse events were reported among 3% of FP-treated children, compared with 2% for BUD.

In conclusion, this study demonstrates that FP for childhood asthma has significantly less impact on childhood growth velocity than a therapeutically equivalent dose of BUD.

Keywords: Children, Asthma, Growth, Fluticasone propionate, Budesonide