Two literature reviews by The Cochrane Collaboration evaluated the effect of inhaled corticosteroids (ICS) on growth in children with asthma. The first review included 25 trials with 8471 children (5128 ICS-treated and 3343 control) with mild to moderate persistent asthma. The second review included 17 group comparisons derived from 10 trials (3394 children with mild to moderate asthma). Trials used ICS (beclomethasone, budesonide, ciclesonide, fluticasone or mometasone) as monotherapy or as combination therapy.
Regular use of ICS at low or medium daily doses was associated with a mean reduction of 0.48 cm/y in linear growth velocity and a 0.61-cm change from baseline in height during a one-year treatment period in children with mild to moderate persistent asthma. The effect size of ICS on linear growth velocity appears to be associated more strongly with the ICS molecule than with the device or dose. ICS-induced growth suppression seems to be maximal during the first year of therapy and less pronounced in subsequent years of treatment. Findings support use of the minimal effective ICS dose in children with asthma.
Asthma Inhalers (click to enlarge the image).
Inhaled corticosteroids in children with persistent asthma: effects on growth. Linjie Zhang et al. DOI: 10.1002/14651858.CD009471.pub2
Inhaled corticosteroids in children with persistent asthma: dose-response effects on growth. Aniela I Pruteanu et al. DOI: 10.1002/14651858.CD009878.pub2