Long-term effect of inhaled corticosteroids on growth rate in adolescents with asthma.
BACKGROUND
Growth in stature in asthmatic adolescents may be delayed compared to normals as a result of treatment with inhaled corticosteroids (CS) or because of a delay in puberty. However, growth rates in asthmatic children have never been studied when treatment with CS was randomized and when growth was compared with that of matched healthy control subjects.


OBJECTIVE
To assess the long-term effect of CS treatment on growth rates in asthmatic adolescents.


METHODS
Participants were 40 asthmatic teenagers (mean age 12.8 years) who received randomized treatment with 0.2 mg of albuterol (salbutamol) with either placebo three times a day (BA + PL) or 0.2 mg of budesonide three times a day (BA + CS) for a median period of 22 months in a double-blind controlled study. Growth rates were compared with those of 80 control subjects who were matched for sex, age, height, and duration of follow-up.


RESULTS
Growth rates in male patients, but not in female patients, were significantly less than in control subjects (P < .05), a finding consistent with a delay of puberty due to asthma. The mean difference (95% confidence interval) in growth rates between patients treated with BA+PL and their controls was -0.70 (-1.62, 0.22) cm/y; that between patients treated with BA + CS and their controls was -0.44 (-1.25, 0.37) cm/y. The observed mean (SEM) case-control difference between treatment groups was +0.27 (0.58) cm/y in favor of BA + CS.


CONCLUSIONS
Growth retardation observed in adolescents with asthma may be due to a delay in puberty but not to the prescription of 0.6 mg of budesonide daily.
Merkus
P J
PJ
Department of Physiology, Leiden University, The Netherlands.
van Essen-Zandvliet
E E
EE
Duiverman
E J
EJ
van Houwelingen
H C
HC
Kerrebijn
K F
KF
Quanjer
P H
PH
D000280:Administration, Inhalation; D000293:Adolescent; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D019819:Budesonide; D016022:Case-Control Studies; D002648:Child; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006128:Growth / Q000187:drug effects*; D006801:Humans; D008297:Male; D011282:Pregnenediones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D001993:Bronchodilator Agents; D005938:Glucocorticoids; D011282:Pregnenediones; D019819:Budesonide