Inhaled corticosteroids in childhood asthma: long-term effects on growth and adrenocortical function.
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.
Salvatoni
Alessandro
A
Pediatric Clinic, University of Insubria, Varese, Italy. alessandro.salvatoni@uninsubria.it
Piantanida
Elena
E
Nosetti
Luana
L
Nespoli
Luigi
L
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001249:Asthma / Q000145:classification / Q000188:drug therapy / Q000503:physiopathology; D001682:Biological Availability; D002648:Child; D002675:Child, Preschool; D006128:Growth / Q000187:drug effects; D006207:Half-Life; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D010913:Pituitary-Adrenal System / Q000187:drug effects*; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones