Current Allergy and Asthma Reports

, Volume 1, Issue 2, pp 122–126 | Cite as

Effects of inhaled corticosteroids on growth in asthmatic children

  • Katherine H. Creese
  • Iolo J. M. Doull
Article

Abstract

This article presents a brief review of the effects of inhaled corticosteroids on growth in children with asthma. All currently available inhaled corticosteroids, where there is adequate data, have been shown to cause significant growth suppression in children in a dose-dependent manner. It is now apparent that there are differences in the growthsuppressive effects of different corticosteroids. Recent evidence confirms that the growth-suppressive effects are short lived and that, at conventional doses, inhaled corticosteroids do not affect final attained adult height.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Pierrepoint MJ, Doull IJM: Inflammation in asthma: the basis for rational therapy. Curr Paediatr 2000, 10:145–149.CrossRefGoogle Scholar
  2. 2.
    Van Essen-Zandvliet EE, Hughes MD, Waalkens HJ, et al.: Effects of 22 months of treatment with inhaled corticosteroids and/or beta 2 agonists on lung function, airway responsiveness and symptoms in children with asthma. Am Rev Respir Dis 1992, 146:547–554.PubMedGoogle Scholar
  3. 3.
    Warner JO: Review of prescribed treatment for children with asthma in 1990. BMJ 1995, 311:663–666.PubMedGoogle Scholar
  4. 4.
    Tinkelman DG, Reed CE, Nelson HS, Offord KP: Aerosol beclomethasone dipropionate compared with theophylline as primary treatment of chronic, mild to moderately severe asthma in children. Pediatrics 1993, 92:64–77.PubMedGoogle Scholar
  5. 5.
    Doull IJM, Freezer NJ, Holgate ST: Growth of prepubertal children with mild asthma treated with inhaled beclomethasone dipropionate. Am J Resp Crit Care Med 1995, 151:1715–1719.PubMedGoogle Scholar
  6. 6.
    Verberne AA, Frost C, Roorda RJ, et al.: One year treatment with salmeterol compared with beclomethasone in children with asthma. Am J Resp Crit Care Med 1997, 156:688–695.PubMedGoogle Scholar
  7. 7.
    Simons FER, Canadian Beclomethasone Dipropionate-Salmeterol Xinafoate Study Group: A comparison of beclomethasone, salmeterol and placebo in children with asthma. N Engl J Med 1997, 337:1659–1665.PubMedCrossRefGoogle Scholar
  8. 8.
    Allen DB, Bronsky EA, LaForce CF, et al.: Growth in asthmatic children treated with fluticasone propionate. J Pediatr 1998, 132:472–477.PubMedCrossRefGoogle Scholar
  9. 9.
    The Childhood Asthma Management Program Research Group: Long term effects of budesonide or nedocromil in children with asthma. N Engl J Med 2000, 343:1054–1063. This 4- to 6-year comparison of BUD, nedocromil, and placebo demonstrated that growth while receiving budesonide is decreased in the 1st year but normal thereafter.CrossRefGoogle Scholar
  10. 10.
    Cohen MB, Welles RR, Cohen S: Anthropometry in children: progress in allergic children as shown by increments in height, weight and maturity. Am J Dis Child 1940, 60:1058–1066.Google Scholar
  11. 11.
    Spock A: Growth patterns in 200 children with bronchial asthma. Ann Allergy 1965, 23:608–615.PubMedGoogle Scholar
  12. 12.
    Kerrebijn KF, De Kroon JPM: Effect on height of corticosteroid therapy in asthmatic children. Arch Dis Child 1968, 43:556–561.PubMedGoogle Scholar
  13. 13.
    Godfrey S, König P: Treatment of childhood asthma for 13 months and longer with beclomethasone dipropionate aerosol. Arch Dis Child 1974, 49:591–596.PubMedGoogle Scholar
  14. 14.
    Francis RS: Long term beclomethasone dipropionate aerosol therapy in juvenile asthma. Thorax 1976, 31:309–314.PubMedGoogle Scholar
  15. 15.
    Godfrey S, Balfour-Lynn L, Tolley M: A three to five year follow up of the use of the aerosol steroid beclomethasone dipropionate in childhood asthma. J Allergy Clin Immunol 1978, 62:335–339.PubMedCrossRefGoogle Scholar
  16. 16.
    Graff-Lonnevig V, Kraepelien S: Long term treatment with Beclomethasone Dipropionate aerosol in asthmatic children with special reference to growth. Allergy 1979, 34:57–61.PubMedCrossRefGoogle Scholar
  17. 17.
    Littlewood JM, Johnson AW, Edwards PA, Littlewood AE: Growth retardation in asthmatic children treated with inhaled beclomethasone dipropionate. Lancet 1988, 1:115–116.PubMedCrossRefGoogle Scholar
  18. 18.
    Hauspie RC, Gyenis G, Alexander F, et al.: Heights and weights of Hungarian and Belgian boys. Hum Biol 1979, 51:507–521.PubMedGoogle Scholar
  19. 19.
    Ferguson AC, Murray AB, Wah-Jun T: Short stature and delayed skeletal maturation in children with allergic disease. J Allergy Clin Immunol 1982, 69:461–466.PubMedCrossRefGoogle Scholar
  20. 20.
    Martin AJ, Landau LI, Phelan PD: The effect of growth on childhood asthma. Acta Paediatr Scand 1981, 70:683–688.PubMedGoogle Scholar
  21. 21.
    Balfour-Lynn L: Growth and childhood asthma. Arch Dis Child 1986, 61:1049–1055.PubMedGoogle Scholar
  22. 22.
    Shohat M, Shohat T, Kedem R, et al.: Childhood asthma and growth outcome. Arch Dis Child 1987, 62:63–65.PubMedGoogle Scholar
  23. 23.
    Wolthers OD, Pedersen S: Short term linear growth in asthmatic children during treatment with prednisolone. BMJ 1990, 301:145–148.PubMedGoogle Scholar
  24. 24.
    Wolthers O, Pedersen S: Growth of asthmatic children during treatment with budesonide: a double blind trial. BMJ 1991, 303:163–165.PubMedGoogle Scholar
  25. 25.
    Wolthers O, Pedersen S: Controlled study of linear growth in asthmatic children during treatment with inhaled glucocorticosteroids. Pediatrics 1992, 89:839–842.PubMedGoogle Scholar
  26. 26.
    MacKenzie CA, Wales JK: Growth of asthmatic children. BMJ 1991, 303:416.Google Scholar
  27. 27.
    Wolthers O, Pedersen S: Short term growth during treatment with inhaled fluticasone propionate and beclomethasone dipropionate. Arch Dis Child 1993, 68:673–676.PubMedGoogle Scholar
  28. 28.
    Agertoft L, Pedersen S: Short term knemometry and urine cortisol excretion in children treated with fluticasone propionate and budesonide: a dose response study. Eur Respir J 1997, 10:1507–1512.PubMedCrossRefGoogle Scholar
  29. 29.
    Visser MJ, van Aalderen WM, Elliott BM, et al.: Short term growth in asthmatic children using fluticasone propionate. Chest 1998, 113:584–586.PubMedGoogle Scholar
  30. 30.
    Hermanussen M, Burmeister J: Standards for the predictive accuracy of short term body height and lower leg length measurement on half annual growth rates. Arch Dis Child 1989, 64:259–263.PubMedCrossRefGoogle Scholar
  31. 31.
    Doull IJM, Campbell MJ, Holgate ST: Duration of growth suppressive effects of regular inhaled corticosteroids. Arch Dis Child 1997, 78:172–173.Google Scholar
  32. 32.
    Sharek PJ, Bergman DA: The effect of inhaled steroids on the linear growth of children with asthma: a meta-analysis. Pediatrics 2000, 106:E8. This meta-analysis demonstrated that BDP decreases growth by 1.5 cm/y.PubMedCrossRefGoogle Scholar
  33. 33.
    Rao R, Gregson RK, Jones AC, et al.: Systemic effects of inhaled corticosteroids on growth and bone turnover in childhood asthma: a comparison of fluticasone and beclomethasone. Eur Respir J 1990, 13:87–94.Google Scholar
  34. 34.
    Agertoft L, Pedersen S: Effect of long term treatment with inhaled budesonide on adult height in children with asthma. N Engl J Med 2000, 343:1064–1069. In this longitudinal follow-up of over 300 children, BUD caused decreased growth when initiated, but there were no long-term effects on growth, and attained adult height was normal.PubMedCrossRefGoogle Scholar
  35. 35.
    Crowley S, Hindmarsh PC, Mathews DR, Brook CGD: Growth and the growth hormone axis in prepubertal children with asthma. J Pediatr 1995, 126:297–303.PubMedCrossRefGoogle Scholar
  36. 36.
    Wolthers OD, Hansen M, Juul A, et al.: Knemometry, urine cortisol excretion, and measures of the insulin-like growth factor axis and collagen turnover in children treated with inhaled glucocorticosteroids. Pediatr Res 1997, 41:44–50.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc. 2001

Authors and Affiliations

  • Katherine H. Creese
    • 1
  • Iolo J. M. Doull
    • 1
  1. 1.Cystic Fibrosis/Respiratory Unit, Department of Child HealthUniversity Hospital of WalesCardiffUK

Personalised recommendations