Inhaled corticosteroids used for the control of asthma in a “real-life” setting do not affect linear growth velocity in prepubertal children
Damir Erceg, Natasa Nenadic, Davor Plavec, Boro Nogalo, Mirjana Turkalj
Med Sci Monit 2012; 18(9): CR564-568
Background: Recent guidelines recommend inhaled corticosteroids as the first-line treatment for persistent asthma. However, long-term corticosteroid treatment in children has raised concerns about potential growth rate deceleration. We aimed to assess the association of growth velocity with the use of inhaled corticosteroids in prepubertal children with asthma in a ”real-life“ setting.
Material/Methods: This study included 844 children aged 4–9.5 years coming to the hospital for regular check-ups between October 2006 and February 2009 for asthma with/without allergic rhinitis and no other known constraints of growth. Out of the 844 children, 790 had all data needed for analysis – 245 children were not treated with ICS, 545 children received ICS (fluticasone, budesonide) with/without INCS (fluticasone, mometasone or budesonide). During the study period, 48 children with/without ICS received short SCS courses.
Results: Mean (SE) height at the first check-up was 123.1 (0.31) cm; range (100.0–147.8 cm). Mean (SE) linear growth velocity (LGV) of the included children was 0.185 (0.0035) mm/day between 2 check-ups. No significant difference was found in LGV between the group not treated with ICS (0.180 mm/day±0.0055) and the group treated with ICS (0.187±0.0044 mm/day). Also, there was no statistical difference between subgroups according to additional therapy with INCS and SCS. No significant correlation was found for LGV and daily dose of ICS (r=0.086, p>0.05).
Conclusions: In our retrospective study using electronic hospital database, ICS and combined use of corticosteroids did not show any association with LGV in prepubertal asthmatic children in a ”real-life“ setting.
Keywords: Child, Preschool, Child, Body Height - drug effects, Asthma - drug therapy, Anti-Asthmatic Agents - pharmacology, Analysis of Variance, Adrenal Cortex Hormones - pharmacology, Administration, Intranasal, Administration, Inhalation, Growth - drug effects, Humans, Retrospective Studies