Children who use steroids for asthma may be shorter than their peers as adults


Cardon Children's asthma educator Kim Reiners, right, a registered nurse, administers a breathing treatment to Kymbrea Valrey, 12, who has chronic asthma, in Mesa, Ariz. A study shows that children who use steroids for asthma may, as adults, be shorter than their peers. (Brad Armstrong/Associated Press/Courtesy of Cardon Children's Medical Center)
September 10, 2012
Asthma
Children who receive corticosteroids for asthma may end up a bit shorter

THE QUESTION Steroid medications taken for asthma can cause growth to slow in children who have not reached puberty. Is this lasting, or might the children catch up by the time they reach their adult height?

THIS STUDY involved 943 young adults who, as 5-to-13-year-olds with mild to moderate asthma, had participated in a study in which they had been randomly assigned to take a corticosteroid (budesonide/Pulmicort), a non-steroid medication (nedocromil/Tilade) or a placebo, all dry powders inhaled through the mouth twice a day for about four years. In that time, the growth rate slowed among the children using the steroid, especially those who had not reached puberty. Subsequently, they were measured periodically until they had reached their adult height, at an average age of 25. At that point, those who had used the steroid remained, on average, a half-inch shorter than the others.

WHO MAY BE AFFECTED? Children with chronic asthma. Corticosteroid medications, which suppress inflammation, are a standard treatment for asthma because they help control symptoms and improve lung function. More than 25 million people in the United States have asthma, and it has become increasingly common in children.

CAVEATS Study participants were given 400 micrograms of budesonide daily as children, but studies since then have shown success with a lower dose; whether taking a lower dose would affect the findings is unclear. Nedocromil is no longer available in the United States as an oral inhaler. The study authors noted that the effect on height “must be balanced against the large and well-established benefit of these drugs in controlling persistent asthma.”

FIND THIS STUDY Sept. 3 online issue of the New England Journal of Medicine (www.nejm.org).

LEARN MORE ABOUT asthma at www.nhlbi.nih.gov/health and www.lung.org/lung-disease.

Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.

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