PEDIATRICS Vol. 108 No. 5 November 2001, pp. 1234-1235
| The first 20% of the full text of this article appears below. |
To the Editor.
I read with interest the meta-analysis of Sharek and Bergman1 regarding the effect of inhaled corticosteroids (ICS) on growth, and felt it was important to address 2 issues in response. First, the authors' analysis of the growth effect seen during treatment with fluticasone propionate (FP) 200 µg/day indicated a small but statistically significant reduction in growth rate compared with placebo. This differs from the nonsignificant P value reported in our original paper,2 and an explanation for this discrepancy is required. Second, the conclusions arrived at by the authors are nevertheless weakened by a failure to review other growth studies in which FP was the active comparator. The result is a message that may be confusing to practitioners caring for children with asthma.
I would like to begin by addressing the different conclusion arrived at
by Drs Sharek and Bergman regarding the effect on growth with FP 200 µg/day. As indicated in our study, we compared the effect of FP 100 µg/day and FP 200 µg/day with placebo in prepubescent
children.2 The data for the children who remained
prepubertal throughout the study were analyzed by analysis of variance
(ANOVA) controlling for investigator. We reported