Effects of inhaled mometasone furoate on growth velocity and adrenal function: a placebo-controlled trial in children 4-9 years old with mild persistent asthma.

Author(s): Skoner DP, Meltzer EO, Milgrom H, Stryszak P, Teper A, Staudinger H

Affiliation(s): Allegheny General Hospital, Pittsburgh, PA 15212, USA. dskoner@wpahs.org

Publication date & source: 2011-10, J Asthma., 48(8):848-59. Epub 2011 Aug 22.

Publication type: Research Support, Non-U.S. Gov't

OBJECTIVE: To assess the effects of long-term mometasone furoate delivered via a dry powder inhaler (MF-DPI) on growth velocity and hypothalamic-pituitary-adrenal axis function in children with asthma. STUDY DESIGN: Children aged 4-9 years with asthma (n = 187) were randomized to MF-DPI 100 mug (delivered dose; actuated dose is 110 mug) once daily in the morning (QD AM), 100 mug twice daily (BID), 200 mug QD AM, or placebo for 52 weeks followed by a 3-month follow-up period. The primary outcome was growth velocity calculated from stadiometric heights recorded at each visit. Secondary outcomes included serum and 12-h urinary cortisol, serum osteocalcin, and urinary N-telopeptide. RESULTS: MF-DPI 100 mug QD AM treatment did not significantly affect growth velocity compared with placebo (-0.10 +/- 0.31 cm/y, p = 0.76). When the effect of a total daily dose of 200 mug MF-DPI on growth velocity was examined, no significant effect was demonstrated for MF-DPI 100 mug BID compared with placebo (-0.64 +/- 0.39 cm/y, p = 0.10), although the change in mean growth velocity with MF-DPI 200 mug QD AM reached statistical significance (-0.70 +/- 0.29 cm/y, p = 0.02). The effects of all examined doses of MF-DPI on mean plasma cortisol levels were similar to cortisol changes seen in the placebo group, suggesting an absence of drug-related effects. No differences in 12-h urinary cortisol or other outcomes were observed between groups. CONCLUSIONS: One year of treatment with a total daily dose of 100 mug of MF-DPI in the morning resulted in no significant difference, whereas a total daily dose of 200 mug of MF-DPI was associated with some changes in growth velocity when compared with placebo. The differences in growth velocity, and the absence of drug-related cortisol effects, support the use of a total daily dose of 100 mug of MF-DPI in children aged 4-9 years with mild persistent asthma.