Article
A randomised controlled trial of short term growth and collagen
turnover in asthmatics treated with inhaled formoterol and budesonide
Carsten Heucka, Lene Heickendorffb, Ole D Wolthersc
a Department of
Paediatrics, Skejby Sygehus, Aarhus University Hospital, Aarhus,
Denmark, b Department of Clinical
Biochemistry, Aarhus Amtssygehus, Aarhus University Hospital, c Department of Paediatrics, Randers
Hospital, Randers, DK-8900 Randers, Denmark
Correspondence to: Dr Wolthers email: o.d.wolthers{at}dadlnet.dk
Accepted 4 May 2000
AIMS
To determine effects on short
term growth and collagen turnover of adding formoterol (Eformoterol) to
half the glucocorticoid dose in children with asthma, treated with
inhaled budesonide (Pulmicort Turbuhaler).
DESIGNA randomised double blind,
placebo controlled crossover study with two six-week periods.
SETTINGOutpatient clinic in
secondary referral centre.
SUBJECTSA total of 27 prepubertal
children aged 6-13 years.
INTERVENTIONSFormoterol 12 µg
and dry powder budesonide 100 µg twice daily in one period; placebo
and dry powder budesonide 200 µg twice daily in the other.
OUTCOME MEASURESPrimary outcome
measures were lower leg growth rate, and serum and urine markers of
type I and type III collagen turnover. Secondary outcome measures were
inflammation markers in serum, and parameters of asthma control.
RESULTSDuring budesonide 200 µg
twice daily treatment, mean lower leg growth rate was 0.14 mm/week
(p = 0.02) lower than during the formoterol and budesonide period.
Similar statistically significant effects on markers of collagen
turnover were found, whereas inflammation markers and asthma control
did not vary statistically significantly between the two periods.
CONCLUSIONSIn children treated
with inhaled glucocorticoids, halving the dose and adding formoterol is
associated with faster short term growth and an increase in markers of
collagen turnover, with no loss of asthma control.
Keywords: asthma; growth; inhaled glucocorticoids; formoterol; collagen turnover; bronchial inflammation
© 2000 by Archives of Disease in Childhood
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