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Long-, intermediate- and short-term growth studies in asthmatic children treated with inhaled glucocorticosteroids
1Department of Paediatrics, Aarhus University Hospital, Denmark.
Insights
New auxological techniques assess growth suppression risk in asthmatic children on glucocorticosteroids. Standard inhaled doses do not affect growth rates, but long-term data is crucial.
Area of Science:
- Pediatric Endocrinology
- Respiratory Medicine
- Auxology
Background:
- Asthmatic children treated with glucocorticosteroids face risks of growth suppression.
- Auxological techniques have advanced for assessing these risks.
- Distinguishing between short-, intermediate-, and long-term growth studies is critical.
Purpose of the Study:
- To review available long-, intermediate-, and short-term growth studies.
- To discuss the importance of different study durations in evaluating growth.
- To analyze the impact of inhaled glucocorticosteroids on child growth.
Main Methods:
- Review of existing literature on growth studies in asthmatic children.
- Analysis of data from short-term lower leg growth rate assessments using knemometry.
- Evaluation of intermediate- and long-term height growth data.
Main Results:
- Short-term lower leg growth rates do not reliably predict long-term height.
- Current evidence suggests standard pediatric doses of inhaled glucocorticosteroids do not impact growth rate.
- Further research is needed on specific glucocorticosteroids, doses, and delivery systems.
Conclusions:
- Intermediate- and short-term growth data require long-term perspective for accurate evaluation.
- Standard inhaled glucocorticosteroid doses appear safe for growth in asthmatic children.
- Continued research should focus on nuanced effects of different corticosteroid therapies on growth.
Abstract:
During recent years, new auxological techniques have been introduced for assessment of the risk of growth suppression in asthmatic children treated with exogeneous glucocorticosteroids. Assessment of lower leg growth rates with the knemometer has made short-term studies of growth processes under strictly controlled conditions possible. However, short-term lower leg growth rates cannot be used for estimations of intermediate-term height growth rates or long-term evaluations of final height. Consequently, the distinctions between the various types of growth studies in asthmatic children treated with inhaled glucocorticosteroids have become important and need to be discussed. The present paper presents a review of the long-, intermediate- and short-term growth studies available. The bulk of evidence from intermediate- and short-term evaluations indicates that growth rate is not affected when standard paediatric doses of inhaled glucocorticosteroids are used. However, further focus needs to be placed on differences between specific glucocorticosteroids, doses and delivery systems. Intermediate- and short-term growth data should be evaluated in the long-term perspective.