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03-09-2012 | General practice | Article

ICSs have lasting impact on height

Abstract

N Engl J Med 2012; Advance online publication

medwireNews: Children whose growth is impaired as a result of taking inhaled corticosteroids (ICSs) for asthma end up being shorter in adulthood, shows research that refutes the common belief that these youngsters will simply 'catch up' as they get older.

The study found that the initial reduction in height associated with ICS use in prepubertal children persisted into adulthood.

The effect was neither progressive nor cumulative. So, the reduction in adult height was similar to that seen after 2 years of treatment, report Dr William Kelly (University of New Mexico, Albuquerque, USA) and colleagues in the New England Journal of Medicine.

They found that children who had taken the ICS budesonide 400 µg daily for 4-6 years from the age of 5-13 years reached an adjusted mean adult height 1.2 cm lower than that of children who took placebo (171.1 vs 172.3 cm).

This compared with a deficit in height of 1.3 cm after 2 years of treatment, and of 1.2 cm at the end of the randomised trial (after a mean of 4.3 years of follow-up).

The authors acknowledge that "the potential effect on adult height must be balanced against the large and well-established benefit of these drugs in controlling persistent asthma".

But they conclude: "It is appropriate to use the lowest effective dose for symptom control in order to minimize concern about the effects of inhaled glucocorticoids on adult height."

medwireNews (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price