Asthma, growth and inhaled corticosteroids

Area of Science:

• Pediatrics
• Endocrinology
• Pulmonology

Background:

• Linear growth is a three-phase process: infancy (nutrition), childhood (hormonal control), and puberty (sex steroid-mediated growth spurt).
• Asthma and its treatments can influence growth, necessitating careful consideration during assessment.
• Oral corticosteroids are known to retard growth, potentially via adrenal suppression and effects on growth hormone secretion.

Purpose of the Study:

• To evaluate the impact of inhaled corticosteroids on linear growth in children with asthma.
• To differentiate between the effects of asthma itself and its treatment on growth patterns.

Main Methods:

• Review of existing literature on linear growth, hormonal control, and corticosteroid effects.
• Analysis of studies using knemometry to measure short-term growth deceleration.
• Consideration of factors influencing growth, including genetics and environment.

Main Results:

• Asthmatic children often exhibit slower growth rates and delayed puberty, typically without affecting final adult height.
• Inhaled corticosteroids have shown short-term growth deceleration in some studies.
• No conclusive evidence indicates long-term growth suppression with conventional inhaled corticosteroid doses.

Conclusions:

• While inhaled corticosteroids may cause transient growth deceleration, they do not appear to cause significant long-term growth impairment at standard doses.
• Growth monitoring is advised for children using inhaled corticosteroids above 0.8 mg/day.
• Adequate asthma control remains the primary objective, with growth assessment as a secondary consideration.