Asthma Treatment Affects Growth

Inhaled corticosteroids are a mainstay of asthma treatment. These puffers include brand name products such as Advair, Flovent, Pulmicort and Symbicort. Doctors have long assumed that such inhaled drugs only exerted their effects in the lungs and did not circulate throughout the body. A new study in The New England Journal of Medicine demonstrates, however, that children who took inhaled steroids to treat their asthma were shorter than their placebo-treated counterparts.
In this study researchers randomly assigned 943 school age kids between the ages of 5 and 13 to one of three treatments. About a third were given the inhaled steroid Pulmicort. Another third received a non-steroidal inhaled asthma drug called Tilade and the final third received placebo. When the children reached their adult height, the researchers found that those on the inhaled steroid were about half an inch shorter than the other children in the study.
Although some experts have downplayed the importance of such a small difference in height, it indicates that the steroids have had systemic effects throughout the body. Whether this means that these young people will be at increased risk for cataracts, glaucoma, diabetes, osteoporosis or other complications of steroid treatment as they grow older is unknown. The investigators emphasize that children being treated for asthma should receive the lowest effective dose of inhaled steroids.
[New England Journal of Medicine, Sept. 6, 2012]