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Inhaled Steroids Get a Boost

Asthma Medications Don't Stunt Childhood Growth
By
WebMD Health News

May 25, 2004 (Orlando, Fla.) -- Parents of growing children who take inhaled steroids for asthma may now be able to breathe a little easier. The longest, largest study to look at whether the drugs stunt childhood growth shows that long-term use of inhaled steroids does not prevent children from reaching their expected adult height.

"If a child is older than 11 years when he or she starts take inhaled corticosteroids, there's no adverse effect on growth at all," says author Soren Petersen, MD, PhD, professor of pediatric respiratory medicine at the University of South Denmark in Odense.

"If they're 6 to 11 years, there's a small effect that's much more marked in the beginning and gone after three years." But by five years after starting inhaled steroids , even kids in this younger age, can compensate and attain the same height as other youngsters their age, he tells WebMD.

He presented his study at the 100th International Conference of the American Thoracic Society in New York City.

Petersen says that previous studies show that these medications prevent normal growth in children. He says many of these studies had too few children or were of such short duration to detect differences in growth between children using inhaled steroids and other normally growing children.

"We hope that our study, which followed nearly 3,000 boys and girls for five years, will lay the issue to rest," he says.

Corticosteroids are a cornerstone of asthma treatment; these drugs reduce the frequency and severity of asthma attacks (corticosteroids should not be confused with anabolic steroids, which are occasionally used illegally by athletes).

A Case of Genetic Adaptation?

The study involved nearly 3,000 children, aged 5 years to 15 years, with mild persistent asthma. While they continued to take their usual asthma medication, some of the children were also treated with the inhaled corticosteroid, while another group of children received placebo.

The average height of the children aged 5 years to 10 years, who were given the inhaled steroid, was about half an inch less than that of kids given placebo, after three years of treatment. The most striking difference in height was in the first year after treatment began, Petersen says.

But by five years, there was no difference in height between the two groups, he says.

Children who started taking the medication when they were older (aged 11 to 15 years old) did not have a decrease in their height compared with similar-aged children taking placebo, he says.

While the researchers only studied Pulmicort, Petersen says he expects that the results apply to other inhaled corticosteroids as well.

Hossein Sadeshi, MD, assistant clinical professor of pediatric pulmonology at Columbia University in New York City, says he will use the new findings to ease patients' concerns. "The study is large and well designed," he tells WebMD. "It provides us with general guidelines we can follow on the effects of corticosteroids."

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