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 children.
"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.
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 Glaxo-Wellcome.
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."
- Allergic rhinitis is a common disease that affects up to 10% of children and 20% of adolescents and adults.
- Two studies evaluated Nasonex and Vancenase, two intranasal steroid sprays used to treat allergies, and found both were effective, but Vancenase was found to slightly suppress childhood growth.
- Researchers caution that the growth suppression is very small, does not affect all children, and is not cause to take children off the drug if they are doing well on it.