Two new reviews of inhaled corticosteroids find that these drugs can lead to growth retardation in children. Such results cause serious concern for doctors and parents of young patients..
Asthma is a chronic respiratory disease that is one of the most common in the United States.. About 25 million Americans (1 in 25 people) have asthma, according to the Centers for Disease Control and Prevention (CDC).. This percentage is even higher among the younger generation - today 6.8 million children in the US (9.3%) are diagnosed with asthma..
The National Heart, Lung, and Blood Institute (NHLBI) states that inhaled corticosteroids (ICS) are the drugs of choice for long-term asthma control and that they are most effective at reducing inflammation and swelling in the airways, which.
The NHLBI also states that young children, who often have respiratory tract infections, are the most likely to develop asthma.. This fact suggests that in this group of children the likelihood of using inhaled corticosteroids is higher..
Inhaled corticosteroids and growth.
A group of authors collaborated on two systematic reviews of the use of inhaled corticosteroids published in the public domain in the Cochrane Library. One study focused on the effect of ICS on growth rate compared to placebo and nonsteroidal drugs.. The second study focused on examining the effects of different doses of ICS..
Impact of ICS on Growth.
The first systematic review looked at 25 studies involving a total of 8,471 children with mild to moderate asthma.. Of these, 14 studies (5,717 participants) assessed the effect of ICS on child growth over 1 year.
Most commonly used inhaled corticosteroids have been tested. The results of the analysis showed that ICS suppressed the growth of children when compared with placebo and nonsteroidal drugs.. In the control groups, the average growth rate of children was 6-9 centimeters per year, and in the group on steroid drugs - an average of 0.5 cm / year less.
Reviewer Linjie Zhang, from the Faculty of Medicine at the Federal University of Rio Grande, Brazil, says that growth retardation "
Effect of different doses of ICS on growth.
The second systematic review included 22 studies that were conducted in children with asthma who took low or moderate doses of inhaled corticosteroids.. In total, these studies tested almost all common ICS at different doses..
Three studies (728 participants) followed children's growth over 3 years. One of these studies included three different treatment regimens. From these studies, it can be concluded that low doses of ICS even accelerate the growth of children by 0.25 centimeters per year..
Need for further research.
Scientists note that in different studies, the effect of ICS on the growth rate of children varies..
The researchers note with regret that in these studies different drugs were not directly compared, so "
One of the limitations of the last work, the authors consider the insufficient duration of all studies (no more than 3 years, and only in three papers).
Professor Francine Ducharme of the Department of Pediatrics at the University of Montreal in Canada, who co-authored the second review, said: “Only 14% of the studies we reviewed spanned more than 1 year.. This is cause for concern. For the time being, we recommend using only the lowest effective doses of ICS in children, and growth during treatment should be clearly documented and tracked.”.
medbe. en.