GROWTH OF PREPUBERTAL CHILDREN WITH MILD ASTHMA TREATED WITH INHALED BECLOMETHASONE DIPROPIONATE

Poorly controlled severe asthma can lead to growth impairment in child hood. In children with mild asthma, it is less clear whether treatment influences growth or adrenal function. We determined in a randomized, double-blind, placebo-controlled, community-based study, the effect o f inhaled beclomethasone dipropionate (BDP) 400 mu g/day for 7 mo on t he linear growth and adrenal function of 94 children 7 to 9 yr of age. Height was measured at least monthly during treatment, and adrenal fu nction assessed by overnight urinary cortisol at baseline and after 3 and 6 mo of treatment. Mean regressed daily growth was significantly d ecreased during the treatment period in the BDP-treated group, 0.79 ve rsus 1.14 mm/wk (difference 0.35 mm/wk; 95% CI -0.46 to -0.25; p < 0.0 001). At the end of the 7 mo, the BDP-treated children had grown signi ficantly less than the children on placebo: mean of 2.66 versus 3.66 c m (difference 1.0 cm; 95% CI -1.36 to -0.64 cm; p < 0.0001). Growth wa s significantly decreased in both males and females. During a washout period of 4 mo there was no significant catch-up growth. BDP had no ef fect on overnight urinary cortisol production. BDP at a dose taken by many children significantly decreases statural growth in children with mild asthma, and this effect is unlikely to be mediated through the h ypothalamo-pituitary-adrenal axis.