Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis
Objective To assess the relationship between inhaled corticosteroids (ICS) use and lung function decline in children with cystic fibrosis (CF) using the Epidemiologic Study of Cystic Fibrosis, an observational study of patients with CF in North America. Study design We analyzed data from 2978 patien...
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| Veröffentlicht in: | The Journal of pediatrics 2008-12, Vol.153 (6), p.746-751.e2 |
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| container_title | The Journal of pediatrics |
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| creator | Ren, Clement L., MD Pasta, David J., MS Rasouliyan, Lawrence, MPH Wagener, Jeffrey S., MD Konstan, Michael W., MD Morgan, Wayne J., MD, CM |
| description | Objective To assess the relationship between inhaled corticosteroids (ICS) use and lung function decline in children with cystic fibrosis (CF) using the Epidemiologic Study of Cystic Fibrosis, an observational study of patients with CF in North America. Study design We analyzed data from 2978 patients 6 to 17 years old enrolled in ESCF between 1994 to 2004. We estimated the rate of decline in forced expiratory volume in 1 second (FEV1 ) before and after starting ICS therapy with a piecewise linear continuous single change point model, adjusting for potentially confounding covariates. Results Before initiation of ICS, mean FEV1 decline was −1.52% predicted/year (95% CI: −1.96 to −1.08% predicted/year). After initiation of ICS therapy, mean FEV1 decline was −0.44% predicted/year (95% CI: −0.85 to −0.03% predicted/year), which was a significant change ( P = .002). ICS use was associated with decreased height for age Z scores and increased insulin/oral hypoglycemic use. Conclusions In this retrospective analysis of prospectively collected data, ICS therapy in patients with CF was associated with a significant reduction in the rate of FEV1 decline, decreased linear growth, and increased insulin/oral hypoglycemic use. |
| doi_str_mv | 10.1016/j.jpeds.2008.07.010 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69803873</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0022347608005921</els_id><sourcerecordid>69803873</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-62321fb972d408db01f3a16b678d6f482a0053b9c359e022fab84fa06e7c1e673</originalsourceid><addsrcrecordid>eNqFksGO0zAQhi0EYrsLT4CEfIFbythOHecA0ipQWKkS0rKcLceeUJfUKXayq749zrYCiQsnX775Z_zNEPKKwZIBk-92y90BXVpyALWEagkMnpAFg7oqpBLiKVkAcF6IspIX5DKlHQDUJcBzcsFUJUHBakHub7E3ox9C2voDbXF8QAz0JmxNj442Qxy9HdKIcfCO3m0xmsORmuDorRmRDh3dTOEHXU_BziH0I9reB6Q-0Gbrexdz2IMft7Q5ppxE176NQ_LpBXnWmT7hy_N7Rb6vP901X4rN1883zfWmsGXJx0JywVnX1hV3JSjXAuuEYbKVlXKyKxU3ACvR1lasasyf7Uyrys6AxMoylJW4Im9PuYc4_JowjXrvk8W-NwGHKWlZKxCqEhkUJ9Dm-VLETh-i35t41Az0rFvv9KNuPevWUOmsO1e9PsdP7R7d35qz3wy8OQMmWdN30QTr0x-O54VIBTJz708cZhn3HqNO1mOw6HxEO2o3-P8M8uGf-nkPPrf8iUdMu2GKIXvWTCeuQX-bL2M-jDwkrGrOxG8fOrRS</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69803873</pqid></control><display><type>article</type><title>Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Ren, Clement L., MD ; Pasta, David J., MS ; Rasouliyan, Lawrence, MPH ; Wagener, Jeffrey S., MD ; Konstan, Michael W., MD ; Morgan, Wayne J., MD, CM</creator><creatorcontrib>Ren, Clement L., MD ; Pasta, David J., MS ; Rasouliyan, Lawrence, MPH ; Wagener, Jeffrey S., MD ; Konstan, Michael W., MD ; Morgan, Wayne J., MD, CM ; Scientific Advisory Group and the Investigators and Coordinators of the Epidemiologic Study of Cystic Fibrosis</creatorcontrib><description>Objective To assess the relationship between inhaled corticosteroids (ICS) use and lung function decline in children with cystic fibrosis (CF) using the Epidemiologic Study of Cystic Fibrosis, an observational study of patients with CF in North America. Study design We analyzed data from 2978 patients 6 to 17 years old enrolled in ESCF between 1994 to 2004. We estimated the rate of decline in forced expiratory volume in 1 second (FEV1 ) before and after starting ICS therapy with a piecewise linear continuous single change point model, adjusting for potentially confounding covariates. Results Before initiation of ICS, mean FEV1 decline was −1.52% predicted/year (95% CI: −1.96 to −1.08% predicted/year). After initiation of ICS therapy, mean FEV1 decline was −0.44% predicted/year (95% CI: −0.85 to −0.03% predicted/year), which was a significant change ( P = .002). ICS use was associated with decreased height for age Z scores and increased insulin/oral hypoglycemic use. Conclusions In this retrospective analysis of prospectively collected data, ICS therapy in patients with CF was associated with a significant reduction in the rate of FEV1 decline, decreased linear growth, and increased insulin/oral hypoglycemic use.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2008.07.010</identifier><identifier>PMID: 18760805</identifier><identifier>CODEN: JOPDAB</identifier><language>eng</language><publisher>Maryland Heights, MO: Mosby, Inc</publisher><subject>Administration, Inhalation ; Adolescent ; Adrenal Cortex Hormones - administration & dosage ; Adrenal Cortex Hormones - therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; Biological and medical sciences ; Child ; Cystic Fibrosis - drug therapy ; Cystic Fibrosis - epidemiology ; Cystic Fibrosis - physiopathology ; Epidemiologic Methods ; Errors of metabolism ; Female ; General aspects ; Humans ; Ibuprofen - therapeutic use ; Male ; Maximal Expiratory Flow Rate ; Medical sciences ; Metabolic diseases ; Miscellaneous hereditary metabolic disorders ; Multicenter Studies as Topic ; North America - epidemiology ; Pediatrics ; Retrospective Studies ; Treatment Outcome</subject><ispartof>The Journal of pediatrics, 2008-12, Vol.153 (6), p.746-751.e2</ispartof><rights>Mosby, Inc.</rights><rights>2008 Mosby, Inc.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-62321fb972d408db01f3a16b678d6f482a0053b9c359e022fab84fa06e7c1e673</citedby><cites>FETCH-LOGICAL-c442t-62321fb972d408db01f3a16b678d6f482a0053b9c359e022fab84fa06e7c1e673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022347608005921$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20946806$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18760805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ren, Clement L., MD</creatorcontrib><creatorcontrib>Pasta, David J., MS</creatorcontrib><creatorcontrib>Rasouliyan, Lawrence, MPH</creatorcontrib><creatorcontrib>Wagener, Jeffrey S., MD</creatorcontrib><creatorcontrib>Konstan, Michael W., MD</creatorcontrib><creatorcontrib>Morgan, Wayne J., MD, CM</creatorcontrib><creatorcontrib>Scientific Advisory Group and the Investigators and Coordinators of the Epidemiologic Study of Cystic Fibrosis</creatorcontrib><title>Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objective To assess the relationship between inhaled corticosteroids (ICS) use and lung function decline in children with cystic fibrosis (CF) using the Epidemiologic Study of Cystic Fibrosis, an observational study of patients with CF in North America. Study design We analyzed data from 2978 patients 6 to 17 years old enrolled in ESCF between 1994 to 2004. We estimated the rate of decline in forced expiratory volume in 1 second (FEV1 ) before and after starting ICS therapy with a piecewise linear continuous single change point model, adjusting for potentially confounding covariates. Results Before initiation of ICS, mean FEV1 decline was −1.52% predicted/year (95% CI: −1.96 to −1.08% predicted/year). After initiation of ICS therapy, mean FEV1 decline was −0.44% predicted/year (95% CI: −0.85 to −0.03% predicted/year), which was a significant change ( P = .002). ICS use was associated with decreased height for age Z scores and increased insulin/oral hypoglycemic use. Conclusions In this retrospective analysis of prospectively collected data, ICS therapy in patients with CF was associated with a significant reduction in the rate of FEV1 decline, decreased linear growth, and increased insulin/oral hypoglycemic use.</description><subject>Administration, Inhalation</subject><subject>Adolescent</subject><subject>Adrenal Cortex Hormones - administration & dosage</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Cystic Fibrosis - drug therapy</subject><subject>Cystic Fibrosis - epidemiology</subject><subject>Cystic Fibrosis - physiopathology</subject><subject>Epidemiologic Methods</subject><subject>Errors of metabolism</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Ibuprofen - therapeutic use</subject><subject>Male</subject><subject>Maximal Expiratory Flow Rate</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Miscellaneous hereditary metabolic disorders</subject><subject>Multicenter Studies as Topic</subject><subject>North America - epidemiology</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFksGO0zAQhi0EYrsLT4CEfIFbythOHecA0ipQWKkS0rKcLceeUJfUKXayq749zrYCiQsnX775Z_zNEPKKwZIBk-92y90BXVpyALWEagkMnpAFg7oqpBLiKVkAcF6IspIX5DKlHQDUJcBzcsFUJUHBakHub7E3ox9C2voDbXF8QAz0JmxNj442Qxy9HdKIcfCO3m0xmsORmuDorRmRDh3dTOEHXU_BziH0I9reB6Q-0Gbrexdz2IMft7Q5ppxE176NQ_LpBXnWmT7hy_N7Rb6vP901X4rN1883zfWmsGXJx0JywVnX1hV3JSjXAuuEYbKVlXKyKxU3ACvR1lasasyf7Uyrys6AxMoylJW4Im9PuYc4_JowjXrvk8W-NwGHKWlZKxCqEhkUJ9Dm-VLETh-i35t41Az0rFvv9KNuPevWUOmsO1e9PsdP7R7d35qz3wy8OQMmWdN30QTr0x-O54VIBTJz708cZhn3HqNO1mOw6HxEO2o3-P8M8uGf-nkPPrf8iUdMu2GKIXvWTCeuQX-bL2M-jDwkrGrOxG8fOrRS</recordid><startdate>20081201</startdate><enddate>20081201</enddate><creator>Ren, Clement L., MD</creator><creator>Pasta, David J., MS</creator><creator>Rasouliyan, Lawrence, MPH</creator><creator>Wagener, Jeffrey S., MD</creator><creator>Konstan, Michael W., MD</creator><creator>Morgan, Wayne J., MD, CM</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20081201</creationdate><title>Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis</title><author>Ren, Clement L., MD ; Pasta, David J., MS ; Rasouliyan, Lawrence, MPH ; Wagener, Jeffrey S., MD ; Konstan, Michael W., MD ; Morgan, Wayne J., MD, CM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-62321fb972d408db01f3a16b678d6f482a0053b9c359e022fab84fa06e7c1e673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Administration, Inhalation</topic><topic>Adolescent</topic><topic>Adrenal Cortex Hormones - administration & dosage</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Cystic Fibrosis - drug therapy</topic><topic>Cystic Fibrosis - epidemiology</topic><topic>Cystic Fibrosis - physiopathology</topic><topic>Epidemiologic Methods</topic><topic>Errors of metabolism</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Ibuprofen - therapeutic use</topic><topic>Male</topic><topic>Maximal Expiratory Flow Rate</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Miscellaneous hereditary metabolic disorders</topic><topic>Multicenter Studies as Topic</topic><topic>North America - epidemiology</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ren, Clement L., MD</creatorcontrib><creatorcontrib>Pasta, David J., MS</creatorcontrib><creatorcontrib>Rasouliyan, Lawrence, MPH</creatorcontrib><creatorcontrib>Wagener, Jeffrey S., MD</creatorcontrib><creatorcontrib>Konstan, Michael W., MD</creatorcontrib><creatorcontrib>Morgan, Wayne J., MD, CM</creatorcontrib><creatorcontrib>Scientific Advisory Group and the Investigators and Coordinators of the Epidemiologic Study of Cystic Fibrosis</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ren, Clement L., MD</au><au>Pasta, David J., MS</au><au>Rasouliyan, Lawrence, MPH</au><au>Wagener, Jeffrey S., MD</au><au>Konstan, Michael W., MD</au><au>Morgan, Wayne J., MD, CM</au><aucorp>Scientific Advisory Group and the Investigators and Coordinators of the Epidemiologic Study of Cystic Fibrosis</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2008-12-01</date><risdate>2008</risdate><volume>153</volume><issue>6</issue><spage>746</spage><epage>751.e2</epage><pages>746-751.e2</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><coden>JOPDAB</coden><abstract>Objective To assess the relationship between inhaled corticosteroids (ICS) use and lung function decline in children with cystic fibrosis (CF) using the Epidemiologic Study of Cystic Fibrosis, an observational study of patients with CF in North America. Study design We analyzed data from 2978 patients 6 to 17 years old enrolled in ESCF between 1994 to 2004. We estimated the rate of decline in forced expiratory volume in 1 second (FEV1 ) before and after starting ICS therapy with a piecewise linear continuous single change point model, adjusting for potentially confounding covariates. Results Before initiation of ICS, mean FEV1 decline was −1.52% predicted/year (95% CI: −1.96 to −1.08% predicted/year). After initiation of ICS therapy, mean FEV1 decline was −0.44% predicted/year (95% CI: −0.85 to −0.03% predicted/year), which was a significant change ( P = .002). ICS use was associated with decreased height for age Z scores and increased insulin/oral hypoglycemic use. Conclusions In this retrospective analysis of prospectively collected data, ICS therapy in patients with CF was associated with a significant reduction in the rate of FEV1 decline, decreased linear growth, and increased insulin/oral hypoglycemic use.</abstract><cop>Maryland Heights, MO</cop><pub>Mosby, Inc</pub><pmid>18760805</pmid><doi>10.1016/j.jpeds.2008.07.010</doi><tpages>6</tpages></addata></record> |
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| subjects | Administration, Inhalation Adolescent Adrenal Cortex Hormones - administration & dosage Adrenal Cortex Hormones - therapeutic use Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Biological and medical sciences Child Cystic Fibrosis - drug therapy Cystic Fibrosis - epidemiology Cystic Fibrosis - physiopathology Epidemiologic Methods Errors of metabolism Female General aspects Humans Ibuprofen - therapeutic use Male Maximal Expiratory Flow Rate Medical sciences Metabolic diseases Miscellaneous hereditary metabolic disorders Multicenter Studies as Topic North America - epidemiology Pediatrics Retrospective Studies Treatment Outcome |
| title | Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis |
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