Inhaled corticosteroids in childhood asthma: growing concerns

Inhaled corticosteroids (ICS) are an established treatment for asthma in childhood. Recent data bring to light growing concerns that ICS may have significant effects on growth velocity in children. The Food and Drug Administration (FDA) recently convened a joint meeting to review these data, and to release new class labelling for ICS that notes this potential adverse effect. Additional concerns regarding ICS are also discussed, including other potential adverse effects, difficulty of use, noncompliance, and patient and parental concerns with the safety of ICS. The aim of this article is as follows: to describe the rationale for the use of ICS in children with asthma; to delineate the association of ICS with potential growth suppression in children; to discuss recent FDA class labelling for use of ICS in children; to describe other potential long term effects of ICS in children; and to detail compliance issues in children with asthma treated with ICS.