Adverse effects of inhaled budesonide (800 micro g) on growth and collagen turnover in children with asthma: A double-blind comparison of once-daily versus twice-daily administration

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Abstract

Background

Twice-daily administration of inhaled budesonide (400 micro g) suppresses short-term growth in children with asthma.

Objective

To compare short-term growth and markers of collagen turnover during treatment with 800 micro g of inhaled budesonide administered once daily in the morning and 400 micro g administered twice daily.

Patients

Twenty-four children with asthma aged 5.6 to 12.5 years.

Settings

An outpatient secondary referral center.

Methods

A randomized, double-blind, crossover trial with 2 treatment periods of 4 weeks was conducted, and growth was assessed with a knemometer. The carboxy terminal propeptide of type I procollagen, the amino terminal propeptide of type I procollagen (PINP), the carboxy terminal pyridinoline cross-linked telopeptide of type I collagen, the amino terminal propeptide of type III procollagen (PIIINP), and urinary pyridinoline and deoxypyridinoline were evaluated.

Results

Mean lower leg growth rate (P = .04), PINP (P = .03), and PIIINP (P < .01) were suppressed during twice-daily administration of budesonide, 400 micro g. Otherwise, no statistically significant differences were detected.

Conclusions

As compared with 400 micro g of inhaled budesonide administered twice daily, 800 micro g administered once daily in the morning has a sparing effect on short-term growth and collagen turnover. (J Pediatr 1998;133:608-12)

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