Corticosteroid inhalers given to children to treat asthma can suppress their growth, according to two systematic reviews of scientific literature on the drugs.
A child’s growth slows within the first year of treatment with a steroid inhaler, according to the review published in The Cochrane Library journal.
About 235 million people worldwide are diagnosed with asthma, according to the World Health Organization. Corticosteroid inhalers are considered the first-line treatment for adults and children with persistent asthma. They are responsible for the reduction in asthma deaths, hospital visits and reducing asthma attacks overall.
But parents and doctors are worried about giving powerful steroids to growing kids. Their concerns prompted the review.
Francine Ducharme of the University of Montreal in Canada, who worked on both reviews, says their findings should prompt doctors to give children the minimal effective dose of steroids to treat their asthma.
"Only 14 percent of the trials we looked at monitored growth in a systematic way for over a year," Ducharme said. "This is a matter of major concern given the importance of this topic.
"Growth should be carefully documented in all children treated with inhaled corticosteroids, as well in all future trials testing (them) in children," she added.
"The evidence ... suggests that children treated daily with inhaled corticosteroids may grow approximately half a centimeter less during the first year of treatment," said lead author Linjie Zhang of the Federal University of Rio Grande in Brazil. "But this effect is less pronounced in subsequent years, is not cumulative, and seems minor compared to the known benefits of the drugs for controlling asthma."
"These studies confirm what many have suspected, that inhaled steroids can suppress growth in children," Jon Ayres, a professor of environmental and respiratory medicine at Britain's Birmingham University, told Reuters. "However, the effect seems... small and non-cumulative and many may consider this a risk worth taking compared to the alternative, which is poorly controlled and therefore potentially life threatening asthma."
Image credit: NIAID