Assessing risk of Inhaled corticosteroids on growth in wheezing preschool children
Published Online: August 5, 2011
The impact on height growth of daily long-term inhaled corticosteroid (ICS) therapy in preschool-aged children with recurrent wheezing is controversial. Children with less severe asthma eventually attain adult height in the predicted range. However, these children may demonstrate a delay in height growth, associated with the use of inhalers.
In an upcoming issue of The Journal of Allergy and Clinical Immunology (JACI), Dr. Guilbert et al. evaluated whether particular subgroups of children could be at higher risk for decreased growth from ICS. Children ages 2 and 3 years with recurrent wheezing and at high risk for asthma development were assigned to a two-year treatment period of fluticasone propionate (FP) or placebo and then followed 2 years off study treatment. Height growth was compared between treatment groups.
In the study group as a whole, the FP group did not have significantly less height growth than the placebo-group two years after discontinuation of study treatment. Children 2 years old weighing < 15 kg at enrollment treated with FP had significantly less height growth compared to placebo treated children, possibly due to a higher dose per weight of FP. Thus, the potential for reduced height growth among children on ICS who are two years of age weighing <15 kg should be balanced with the level of asthma control to maximize the benefit-risk ratio of treatment.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.