Short of Breath? Or Just a Little Short?

Inhaled asthma treatment may cause children to be a half inch shorter when fully grown

(RxWiki News) Parents may have to think twice about their children's inhalers before they make the wheeze go away.

Children who use inhaled steroids to treat asthma end up slightly shorter than kids who don't use the drugs, a new research study has found.

The researchers found that the children who took the steroid were half an inch, or 1.2 centimeters, shorter than the other two groups of children who took the non-steroid and fake drugs.

"Talk to your child's doctor about all asthma treatments."

The study, led by Robert Strunk, MD, a pediatrics professor at Washington University School of Medicine, involved 943 children ages 5 to 12 who were treated for mild to moderate asthma.

The kids were part of the Childhood Asthma Management Program (CAMP) clinical trial and were divided into three groups.

One group received an inhaled corticosteroid medication (bedesonide) twice daily, a second group received a non-steroid medication, and a third group received a fake pill.

Inhalers with ingredients such as bedsonide are the most effective form of treatment for asthma.

The children were treated for more than four years at eight centers, including Washington University School of Medicine. All received albuterol, the fast-acting drug to relieve small, short-term cases of asthma.

Researchers followed participants until the girls reached 18-years-old and boys were 20 or older. This was when the kids were considered adult height.

The height and weight of each child was recorded every six months during the first four and half years of the study.

Over the next eight years, height and weight were measured once or twice a year.

The kids' gender, age when they started the study, and length of time they had asthma were taken into account. Researchers also considered each child's ethnicity, severity of asthma, and allergies.

Kids who started taking the steroid between 5 and 11-years-old grew the slowest, which happened during the first two years of the four-year study.

“This was surprising because in previous studies, we found that the slower growth would be temporary, not affecting adult height,” Dr. Strunk said in a press release.

“But none of those studies followed patients from the time they entered the study until they had reached adult height.”

The children's gender, how long they had asthma, and the height of their parents, didn't affect results, the authors said.

Strunk said that asthma specialists at St. Louis Children's Hospital carefully watch children's growth as they take the steroid treatment.

“If a child is not growing as they should, we may reduce their steroid dose,” he said.

“But we think that the half-inch of lowered adult height must be balanced against the well-established benefit of inhaled corticosteroids in controlling persistent asthma. We will use the lowest effective dose to control symptoms to minimize concerns about effects on adult height.”

Grants from the National Heart, Lung and Blood Institute of the National Institutes of Health and General Clinical Research Center supported the study.

The authors served on various asthma and health committees, and received consulting fees, lecture fees, and grants to fund their study. They do not declare any other conflicts of interest.

The study was published online Sept. 3 in the New England Journal of Medicine.

Review Date: 
September 3, 2012