Inhaled corticosteroids and growth.
Since inhaled corticosteroids may circulate systemically, a risk of growth suppression in asthmatic children treated with these drugs cannot be ruled out. When assessing the risk, specific drugs, delivery systems, doses, administration regimens, and compliance with treatment regimens must be considered. Although reassuring results have been reported, methodological flaws have meant that the published follow-up evaluations of final height may not be valid for the sound assessment of any growth effects of inhaled corticosteroids. Short-term studies suggest that twice-daily administration of budesonide 200-400 microg delivered from a metered-dose inhaler with a spacer, dry powder budesonide 200 microg, and fluticasone propionate 200 microg per day in children with mild asthma, are not associated with growth-rate effects. The risk may become significant with budesonide 800 microg administered via a metered-dose inhaler with a spacer, and with 400 microg from a dry powder inhaler. The risk of growth suppression can be reduced by dosing once daily in the morning. In children with severe asthma, high doses of inhaled corticosteroids may be potentially lifesaving and thus outweigh the potential risk of mild growth suppression.
Wolthers
O D
OD
Children's Clinic Randers, Denmark. o.d.wolthers@dadlnet.dk
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D001827:Body Height / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems; D006128:Growth / Q000187:drug effects*; D006801:Humans
D000305:Adrenal Cortex Hormones