Allergy Nasal Spray Might Affect Children's Growth
Feb. 28, 2000 (Minneapolis) -- If your child uses a nasal spray for
allergies, you might want to take heed. Two studies in this month's
Pediatrics go nose-to-nose to evaluate the effects of two commonly
prescribed nasal steroid sprays. One of them, researchers find, can slightly
suppress childhood growth.
Typically, nasal steroid sprays are used to treat allergic rhinitis, a
disease affecting up to 10% of children and 20% of adolescents and adults. The
use of nasal sprays as a first-line therapy for children with persistent
allergic rhinitis has gained acceptance in recent years because the sprays are
well tolerated and effective for treating nasal symptoms.
In the separate studies, researchers evaluated the effects of the two nasal
sprays on childhood growth. Each of the studies followed approximately 100
children for a year. One found no evidence of growth suppression using a new
treatment called Nasonex (mometasone). The other found that an older treatment,
Vancenase (beclomethasone), might slightly slow the growth rate in
"There are definite differences among nasal preparations used to treat
allergies in both children and adults," Eric J. Schenkel, MD, author of the
Nasonex study, tells WebMD. Although Nasonex has been shown to be effective and
safe, it should be taken in the lowest dose possible, he says. Schenkel is
director of the Valley Clinical Research Center in Easton, Pa.
In the study on Vancenase, researchers found that a small percentage of
patients using the medication showed a slight growth suppression as early as a
month after beginning treatment. In an interview with WebMD, lead researcher
David P. Skoner, MD, tells parents that if a child uses this spray in the right
doses on the right timetable, "there's a small chance that he could have a
growth suppressive. However, if the child is doing well, there's no reason to
change." Skoner explains that the growth suppression found in the study
equated to less than half an inch during the yearlong trial. "That's a tiny
amount, and most kids that [take] these drugs don't have growth suppression. We
need to keep all of this in perspective," says Skoner, who is chief of the
Allergy/Immunology Section at the Children's Hospital in Pittsburgh.
Skoner says both Vancenase and Nasonex are good medications. "These
drugs are the best out there to treat [allergies]. Any child who needs them
should get them."
Whether effects on childhood growth seen in some studies will result in
reduced adult height is uncertain. Some studies suggest that if children's
growth is delayed, they will eventually attain their adult height. "We
don't know if they will of if they won't," Schenkel says.
A spokesman for the company that manufactures both drugs says more study is
needed. "While the study results are statistically significant, their
clinical relevance is unknown," Ronald J. Asinari, a spokesperson for
Schering-Plough Corp., tells WebMD. "Schering-Plough believes that the
clinical significance of these results can only be determined with further
investigation. The company stresses that Vancenase is safe and effective when
used properly under a physician's direction." Both of the studies received
funding from Schering-Plough, and the Vancenase study was also supported by
The message to parents, Schenkel says, is: "Use caution. ... Since
Nasonex is the safest steroid out there, it should be the drug of choice in
treating children, without the worry of growth suppression."