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Inhaled Corticosteroids in Childhood Asthma

Long-Term Effects on Growth and Adrenocortical Function

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Abstract

Inhaled corticosteroids (ICS) are the most potent of all the available inhaled treatments, and are effective medications for long-term control of asthma. However, their use in children is limited by the risk of systemic adverse effects. Although results reported in the literature on the adverse effects of ICS are conflicting and often restricted to a small number of cases with a limited follow-up, most of them show an early decrease in growth velocity without significant influence on final adult height. Partial adrenal suppression has also been demonstrated in children treated with ICS for more than 2 months.

Only children with mild persistent, moderate, or severe asthma not controlled by non-corticosteroid drugs should be treated with ICS for long periods. The dose of ICS must be individually adjusted to minimize the possible adverse effects on growth, and all children with asthma receiving long-term treatment with ICS must be regularly evaluated for growth impairment, which may necessitate dose reduction or drug replacement.

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Acknowledgements

We acknowledge Mrs Catriona Cameron for her revision of the English text. The authors have provided no information on sources of funding or on conflicts of interest directly relevant to the content of this review.

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Authors and Affiliations

  1. Pediatric Clinic, University of Insubria, Via Filippo del Ponte, 19, 21100, Varese, Italy

    Alessandro Salvatoni (Associate Professor), Elena Piantanida, Luana Nosetti & Luigi Nespoli

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  1. Alessandro Salvatoni
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  2. Elena Piantanida
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Correspondence to Alessandro Salvatoni.

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Salvatoni, A., Piantanida, E., Nosetti, L. et al. Inhaled Corticosteroids in Childhood Asthma. Pediatr-Drugs 5, 351–361 (2003). https://doi.org/10.2165/00128072-200305060-00001

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