The Journal of Pediatrics
Volume 153, Issue 6 , Pages 746-751.e2 , December 2008

Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis

  • Clement L. Ren, MD

      Affiliations

    • Department of Pediatrics, University of Rochester, Rochester, NY
    • Corresponding Author InformationReprint requests: Clement L. Ren, MD, University of Rochester, 601 Elmwood Ave., Rochester, NY 14642
    • ,
  • David J. Pasta, MS

      Affiliations

    • ICON Clinical Research, San Francisco, CA
    • ,
  • Lawrence Rasouliyan, MPH

      Affiliations

    • ICON Clinical Research, San Francisco, CA
    • ,
  • Jeffrey S. Wagener, MD

      Affiliations

    • Department of Pediatrics, The Children's Hospital and University of Colorado School of Medicine, Denver, CO
    • ,
  • Michael W. Konstan, MD

      Affiliations

    • Department of Pediatrics, Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, OH
    • ,
  • Wayne J. Morgan, MD, CM

      Affiliations

    • Department of Pediatrics and Physiology, University of Arizona, Tucson, AZ
    • ,
  • Scientific Advisory Group and the Investigators and Coordinators of the Epidemiologic Study of Cystic Fibrosis

Received 8 October 2007 ,Revised 19 May 2008 ,Accepted 8 July 2008.

References 

  1. Chmiel JF, Konstan MW. Inflammation and anti-inflammatory therapies for cystic fibrosis. Clin Chest Med. 2007;28:331–346
  2. Eigen H, Rosenstein BJ, FitzSimmons S, Schidlow DV. A multicenter study of alternate-day prednisone therapy in patients with cystic fibrosis (Cystic Fibrosis Foundation Prednisone Trial Group). J Pediatr. 1995;126:515–523
  3. Lands LC, Milner R, Cantin AM, Manson D, Corey M. High-dose ibuprofen in cystic fibrosis: Canadian safety and effectiveness trial. J Pediatr. 2007;151:249–254
  4. Konstan MW, Byard PJ, Hoppel CL, Davis PB. Effect of high-dose ibuprofen in patients with cystic fibrosis. N Engl J Med. 1995;332:848–854
  5. Oermann CM, Sockrider MM, Konstan MW. The use of anti-inflammatory medications in cystic fibrosis: trends and physician attitudes. Chest. 1999;115:1053–1058
  6. Barnes PJ. Inhaled glucocorticoids for asthma. N Engl J Med. 1995;332:868–875
  7. Bisgaard H, Pedersen SS, Nielsen KG, Skov M, Laursen EM, Kronborg G, et al. Controlled trial of inhaled budesonide in patients with cystic fibrosis and chronic bronchopulmonary Psuedomonas aeruginosa infection. Am J Respir Crit Care Med. 1997;156:1190–1196
  8. Nikolaizik WH, Schoni MH. Pilot study to assess the effect of inhaled corticosteroids on lung function in patients with cystic fibrosis. J Pediatr. 1996;128:271–274
  9. Wojtczak HA, Kerby GS, Wagener JS, Copenhaver SC, Gotlin RW, Riches DW, et al. Beclomethasone diproprionate reduced airway inflammation without adrenal suppression in young children with cystic fibrosis: a pilot study. Pediatr Pulmonol. 2001;32:293–302
  10. van Haren EH, Lammers JW, Festen J, Heijerman HG, Groot CA, van Herwaarden CL. The effects of the inhaled corticosteroid budesonide on lung function and bronchial hyperresponsiveness in adult patients with cystic fibrosis. Respir Med. 1995;89:209–214
  11. Balfour-Lynn IM, Klein NJ, Dinwiddie R. Randomised controlled trial of inhaled corticosteroids (fluticasone propionate) in cystic fibrosis. Arch Dis Child. 1997;77:124–130
  12. Schiotz PO, Jorgensen M, Flensborg EW, Faero O, Husby S, Hoiby N, et al. Chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (A longitudinal study of immune complex activity and inflammatory response in sputum sol-phase of cystic fibrosis patients with chronic Pseudomonas aeruginosa lung infections: influence of local steroid treatment). Acta Paediatr Scand. 1983;72:283–287
  13. Balfour-Lynn IM, Lees B, Hall P, Phillips G, Khan M, Flather M, et al. Multicenter randomized controlled trial of withdrawal of inhaled corticosteroids in cystic fibrosis. Am J Respir Crit Care Med. 2006;173:1356–1362
  14. Balfour-Lynn IM, Walters S, Dezateux C. Inhaled corticosteroids for cystic fibrosis (Review). Cochrane Database of Systematic Reviews 2006 2006.
  15. Bush A, Davies J. Non! to non-steroidal anti-inflammatory therapy for inflammatory lung disease in cystic fibrosis (at least at the moment). J Pediatr. 2007;151:228–230
  16. Davis PB, Byard PJ, Konstan MW. Identifying treatments that halt progression of pulmonary disease in cystic fibrosis. Pediatr Res. 1997;41:161–165
  17. Cystic Fibrosis Foundation. Cystic Fibrosis Foundation Patient Registry Annual Report. 2006;Bethesda, MD
  18. Morgan WJ, Butler SM, Johnson CA, Colin AA, FitzSimmons SC, Geller DE, et al. Epidemiologic study of cystic fibrosis: design and implementation of a prospective, multicenter, observational study of patients with cystic fibrosis in the U.S. and Canada. Pediatr Pulmonol. 1999;28:231–241
  19. Wang X, Dockery DW, Wypij D, Fay ME, Ferris BG. Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol. 1993;15:75–88
  20. Konstan MW, Morgan WJ, Butler SM, Pasta DJ, Craib ML, Silva SJ, et al. Risk factors for rate of decline in forced expiratory volume in one second in children and adolescents with cystic fibrosis. J Pediatr. 2007;151:134–139
  21. Gibson RL, Burns JL, Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med. 2003;168:918–951
  22. Minicucci L, Severi G, Cresta L, Giannattasio A, Lorini R, Haupt R. Impact of inhaled corticosteroids on the risk of early Pseudomonas aeruginosa acquisition in cystic fibrosis. Acta Paediatr. 2003;92:684–687
  23. De Boeck K, De Baets F, Malfroot A, Desager K, Mouchet F, Proesmans M. Do inhaled corticosteroids impair long-term growth in prepubertal cystic fibrosis patients?. Eur J Pediatr. 2007;166:23–28
  24. Hordvik NL, Sammut PH, Judy CG, Colombo JL. Effectiveness and tolerability of high-dose salmeterol in cystic fibrosis. Pediatr Pulmonol. 2002;34:287–296

 Financial support and conflict of interest information available at www.jpeds.com (Appendix 2).

PII: S0022-3476(08)00592-1

doi: 10.1016/j.jpeds.2008.07.010

The Journal of Pediatrics
Volume 153, Issue 6 , Pages 746-751.e2 , December 2008

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