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[Adverse events of inhaled steroids in childhood]
Insights
Inhaled corticosteroids are preferred over oral steroids for children. While short-term effects are minimal, long-term impacts on growth and bone health are less concerning with newer medications, though monitoring is advised.
Area of Science:
- Pediatric Endocrinology
- Pharmacology
- Respiratory Medicine
Context:
- Pediatricians express concern regarding inhaled corticosteroid (ICS) adverse events on growth and bone mineralization.
- Differentiating short, intermediate, and long-term effects is crucial for accurate risk assessment.
Purpose:
- To review current data on the adverse effects of inhaled corticosteroids (ICS) in children.
- To provide evidence-based recommendations for pediatricians regarding ICS use and monitoring.
Summary:
- Inhaled corticosteroids are preferable to oral steroids due to fewer systemic adverse events.
- Recent data suggest newer ICS formulations have minimal long-term impact on adult height and bone mineralization.
- Practitioners must be aware of recommendations to minimize ICS adverse events, including monitoring growth and addressing local effects like cough.
Impact:
- Informed clinical practice regarding ICS use in pediatric asthma and other respiratory conditions.
- Improved patient outcomes through optimized therapeutic strategies and reduced adverse event incidence.
- Highlights the need for continued research into long-term ICS effects and optimal monitoring protocols.
Abstract:
The adverse events of the inhaled steroids on growth and bone mineralization concern the pediatricians. From the available current data, we exposed the following conclusions: 1) Inhaled steroids must be preferred to oral steroids; 2) Short, middle and long-term adverse effects of inhaled steroids have to be differentiated. Only the long-term effects reflect possible sequela; 3) The adverse effects are specific from the considered inhaled steroids, the most recent available drugs having less adverse effects on bone and growth; 4) Recent data did not show consequences on the adult height and bone mineralization; 5) Recommendations in the use of inhaled steroids must be known by the practitioners in order to limit the adverse events of these drugs. Growth need to be surveyed in children with inhaled steroids and more studies are still necessary. In addition, we enhanced that local adverse effects should be sought by the physicians. Cough after inhalation was frequent and might be a negative factor of compliance.
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