Effect Of Long Term Inhaled Corticosteroid Therapy On Adrenal Suppression, Growth And Bone Health In Children With Asthma
EFFECT OF LONG TERM INHALED CORTICOSTEROID THERAPY ON ADRENAL SUPPRESSION, GROWTH AND BONE HEALTH IN CHILDREN WITH ASTHMA Anuradha KWDA1, Abstract Background Primary objective was to describe the effect of long term inhaled corticosteroid therapy (ICS) on adrenal suppression, growth and bone health in children with Asthma. Secondary objectives were to describe the association between the dose of ICS and duration of therapy on adrenal functions, growth and bone health in children with asthma,
... ren with asthma, describe their growth ,biochemical parameters associated with bone health and vitamin D levels in comparison to an age and sex matched group of children with asthma who were not on long term ICS. Method Seventy children with asthma on ICS and 70 controls were studied. The estimated adult heights were interpreted relative to their Mid Parental Height (MPH) range. Serum calcium, alkaline phosphatase and vitamin D levels were assayed in both groups and cortisol value at 30 minutes following a low dose short synacthen test was obtained from the study group. The average daily dose of ICS was categorized as low, medium and high (100-200, 200-400, >400 ug /day ) respectively according to published literature. Results Heights of all children were within the MPH range. There was no statistically significant difference in the bone profiles and vitamin D levels between the two groups (Ca: p=0.554, vitamin D: p=0.187) but vitamin D levels were insufficient (<50 nmol/l) in 34% of cases and 41% of controls. Suppressed cortisol levels were seen in 24%. Doses of ICS were low, medium and high in 56%, 32% and 12% of children respectively. The association between adrenal suppression with longer duration of therapy (p<0.01) and with increasing dose of ICS (p<0.001) were statistically significant. Conclusion ICS had no impact on the growth and bone profiles but its dose and duration were significantly associated with adrenal suppression.