title: [Inhaled corticosteroids and growth: should we be worried?].
abstract: Inhaled corticosteroids (ICSs) are the cornerstone and the first stage of asthma treatment. The objective of this study was to synthesize data on the potential effects of ICSs on growth in children. Studies on the short-term impact of ICSs on growth evaluated by knemometry cannot be extrapolated to the medium or long term and therefore have no utility in real life for a given person. In the medium term, the various ICSs given at the usual doses cause a small reduction in growth after 6 months of treatment. This slowdown occurs at the beginning of treatment, especially in younger children, and the growth velocity corrects itself later but without catching up. In the long term, the prolonged use of ICSs seems to induce a small reduction in the final size in adulthood (close to 1cm) occurring in the first 2 years of treatment without worsening over time. The impact of gender, age at onset of treatment, different ICSs, modes of inhalation, and severity of asthma should also be studied further. The benefit of ICSs in asthma treatment is greater than the risk of side effects, including on growth. The majority of the therapeutic effect is obtained for small to moderate doses of ICSs. Regular adjustment of ICS dose for optimal asthma control should also reduce ICS dose and the impact on growth.
authors.affiliation: Service de pédiatrie, centre hospitalier de Roubaix, pavillon de pédiatrie médico-chirurgicale, 11-17, boulevard Lacordaire, BP 359, 59056 Lille, France; Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France. Electronic address: guillaume.pouessel@ch-roubaix.fr.
authors.forename: G
authors.initials: G
authors.lastname: Pouessel
authors.affiliation: Unité d'endocrinologie pédiatrique, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: I
authors.initials: I
authors.lastname: Gueorguieva
authors.affiliation: Service de pédiatrie, centre hospitalier de Roubaix, pavillon de pédiatrie médico-chirurgicale, 11-17, boulevard Lacordaire, BP 359, 59056 Lille, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Bernaczyk
authors.affiliation: Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Flammarion
authors.affiliation: Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Thumerelle
authors.affiliation: Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Deschildre
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D006128:Growth / Q000187:drug effects*; D006801:Humans
chemical_list: D000305:Adrenal Cortex Hormones