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

Clement L. Ren, David J. Pasta, Lawrence Rasouliyan, Jeffrey S. Wagener, Michael W. Konstan, Wayne J Morgan

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
JournalThe Journal of Pediatrics
Volume153
Issue number6
DOIs
StatePublished - Dec 2008

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Cystic Fibrosis
Adrenal Cortex Hormones
Forced Expiratory Volume
Lung
Hypoglycemic Agents
Therapeutics
Insulin
North America
Observational Studies
Epidemiologic Studies
Growth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis. / Ren, Clement L.; Pasta, David J.; Rasouliyan, Lawrence; Wagener, Jeffrey S.; Konstan, Michael W.; Morgan, Wayne J.

In: The Journal of Pediatrics, Vol. 153, No. 6, 12.2008.

Research output: Contribution to journalArticle

Ren, Clement L. ; Pasta, David J. ; Rasouliyan, Lawrence ; Wagener, Jeffrey S. ; Konstan, Michael W. ; Morgan, Wayne J. / Relationship between Inhaled Corticosteroid Therapy and Rate of Lung Function Decline in Children with Cystic Fibrosis. In: The Journal of Pediatrics. 2008 ; Vol. 153, No. 6.
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