Inhaled Steroids Don't Affect Children's Growth in the Long Run
The researchers found that neither drug was better than the placebo in helping overall lung function, but that the corticosteroid, Pulmicort, helped the children to control their asthma better. They had fewer hospitalizations and fewer urgent visits to their doctors. Pulmicort also reduced their need for other asthma medications.
When evaluating growth rates, the researchers found only a very slight difference in the children who were using Pulmicort. The slower growth rate occurred mostly within the first year that they used the drug. At the end of the study, which lasted from four to six years, the three groups all had similar growth rates.
In the second study, Danish researchers Lone Agertoft, MD, and S?ren Pedersen, MD, DrMedSci, of the department of pediatrics at Kolding Hospital in Kolding, Denmark, evaluated the height of 200 adults who had used inhaled Pulmicort as children. Their findings were similar to those of the other study: While the medication affected growth initially, the effect was temporary and did not affect their adult height.
If a child has mild asthma with periodic episodes that require emergency care, hospitalization, or courses of oral steroids, says Szefler, then "there is a distinct possibility that these life-threatening episodes could be alleviated" by using an inhaled corticosteroid.
"Since there are children with very severe asthma who do require steroids, it is very reassuring that the growth rate -- while it goes down in the first year -- is not sustained," says Ira Finegold, MD. "These children are very sick and need their medication, so this may help relieve anxiety about [these medications]." Finegold, who was not involved in the study, is chief of allergy and immunology at St. Luke's-Roosevelt Hospital Center in New York.
But should all children with asthma, regardless of the severity of the disease, use these drugs? In an editorial accompanying the studies, Mary Ellen B. Wohl, MD, and Joseph A. Mazjoub, MD, both professors of pediatrics at Harvard Medical School, still recommend caution when using corticosteroids. One concern is that the steroids may affect the growth of other organs, such as the brain and the lungs.