Growth and adrenal suppression in asthmatic children treated with high-dose fluticasone propionate

G. Todd, K. Dunlop, J. McNaboe, M.F. Ryan, D. Carson, M.D. Shields

Research output: Contribution to journalArticlepeer-review

136 Citations (Scopus)

Abstract

Background: Fluticasone propionate was introduced in 1993 in the UK as a potentially safer inhaled corticosteroid than those already in use. The efficacy and safety of fluticasone has been established at recommended doses of 200 µg/day, but not at the higher doses that are often used.

Methods: Growth retardation was observed in six severely asthmatic children after introduction of high-dose fluticasone propionate treatment (dry powder). Assessment of cortisol response was by insulin-induced hypoglycaemia in three cases, by short tetracosactrin test in two, and by low-dose tetracosactrin and 24-hour urinary cortisol/creatinine ratio in one.

Findings: Six children with growth retardation noted after treatment with high-dose fluticasone propionate were found to have adrenal suppression. In one case the growth rate and cortisol response returned to normal 9 months after the fluticasone dose was reduced to 500 µg/day.

Interpretation: When high doses of fluticasone propionate are used, growth may be retarded and adrenal suppression may occur.
Original languageEnglish
Pages (from-to)27-29
Number of pages3
JournalLancet
Volume348
Issue number9019
DOIs
Publication statusPublished - 06 Jul 1996

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