Inhaled Steroids Don't Affect Children's Growth in the Long Run
Until more is known about the effects of these drugs on the body's other organs, they write, and "until better tools are developed to assess organ growth, it may be prudent to avoid the use of inhaled corticosteroids in young children with very mild asthma."
Bob Lanier, MD, who commented on the studies for WebMD, disagrees. He says that people do need to weigh the risks and benefits of corticosteroid therapy but that the health of children's lungs outweighs the possible risk of growth problems.
"Studies have demonstrated a loss of lung function of at least 1% a year in poorly managed asthma," he says. "I think parents should first be worried about the growth of lungs." Lanier is vice president of the American College of Allergy Asthma and Immunology.
But Finegold says that the editorialists' suggestions are valid. "When we're dealing with mild asthma, especially in very young children, I agree with the editorial that caution is warranted," he says. "In this population, alternate therapies should be assessed."
He points out that for an asthmatic child who also has allergies, for example, parents should consider allergy shots. "Allergy shots have no effect on growth and can decrease the severity of asthma," he says.
"The take-home message is that if your child has asthma, do not be afraid that inhaled steroids will give short stature," says Finegold. "Certainly for moderate to severe asthma, one should use the inhaled steroids without worrying that you're going to have short children."
The Danish study was supported by grants from the Vejle County Hospitals Research Fund; the multicenter study was supported by contracts with the National Heart, Lung, and Blood Institute and General Clinical Research Center grants from the National Center for Research Resources.
Szefler has served as a consultant or advisory panel member for drugmakers Astra USA and Glaxo Wellcome, both of which supplied drugs for his study.