Research finds steroid inhalers could reduce children's growth
Using inhaled corticosteroids could lead to decreased growth rates during the first year of treatment in young patients, a study has found.
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Using steroid inhalers could suppress growth in children, a new study has suggested. Inhaled corticosteroids (ICS), used to treat asthmatics, could decrease growth rates by nearly half a centimetre in young patients during the first year of treatment, according to a study published in the Cochrane Review last week (July 17). The study looked at 25 trials that monitored height in 8,471 children with mild to moderate asthma, and found that low or medium daily doses of ICS decreased the average rate of growth in children by 0.48cm per year when compared to a placebo or non-steroidal drugs. The findings supported using the minimal effective dose of ICS in children with asthma, concluded researchers from the University of Rio Grande in Brazil and the University of Montreal in Canada. The study suggests that growth suppression among children using inhalers containing beclomethasone dipropionate, budesonide, ciclesonide, flunisolide, fluticasone propionate and mometasone furoate is greatest during the first year of treatment and less pronounced thereafter, researchers said. The trials appear to suggest the choice of ICS had more of an effect on growth than the dose or inhaler device used. However, further studies were needed to determine the effects of high ICS doses or intermittent use compared with regular use. Children using fluticasone in one of the trials showed "accelerated" growth in the 12 months after treatment ended, but average height was still 0.7cm shorter than the placebo groups. Another trial found pre-pubescent children treated with budesonide for four years were an average of 1.2cm shorter by the time they reached adulthood. The researchers said it would be "prudent" to monitor growth in children treated with ICS, given that the effects of the drugs could "vary considerably" depending on the individual. However, this growth suppression was "minor" when compared with the benefits of the drugs, which controlled asthma and ensured full lung growth, said lead author Linjie Zhang, associate professor at the Federal University of Rio Grande.
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