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Long-term ICS use in children with asthma slightly impacts annual growth velocity

Using inhaled corticosteroids for more than 12 months in children with asthma appeared to minimally reduce growth velocity and final adult height, according to study results.

“Inhaled corticosteroids do not cause much loss of height in children, and any reduction in height in adulthood is likely to be imperceptible,” Yoon Kong Loke, MD, a professor of medicine and pharmacology at University of East Anglia in the U.K., told Healio.com/Allergy.

Yoon Kong Loke

Loke and colleagues searched Medline and Embase in July 2013, followed by a PubMed search in December 2014 to assess the association between long-term inhaled corticosteroid (ICS) use and growth in children.

The researchers included 20 randomized control trials (RCTs) and three observational studies in their research.

ICS use appeared more likely to reduce growth velocity in children with asthma (–0.48 cm/year) compared with placebo in 16 RCTs and one observational study.

One long-term RCT of budesonide showed that 4 years of the use of the drug appeared associated with a mean difference in final adult height of –1.2 cm compared with participants on placebo.

People should take precautions when interpreting the results, however. Most of the studies involved commercial sponsors, which may have lent the possibility of benefits being emphasized and harms presented in less detail, according to the researchers.

Loke told Healio.com/Allergy that the impact on height appeared very minimal unless participants used ICS over several years.

“ICS are only problematic when continuously used in higher doses for very long periods in younger children,” he said. – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.