Study: Asthma Inhaler use in Children Stunts Growth

Child with inhaler

The Guardian recently covered two asthma studies regarding inhaler usage and growth in children. The studies were conducted by Francine Ducharme, a pediatrician at the University of Montreal. The first study analyzed published inhaler usage trials of over 8,400 children. Results showed that the growth rate for children under 18 without steroid usage exceeded the growth rate for children using steroids by approximately half a centimeter per year.

The second study followed children who were taking medication doses between 50 to 200 micrograms of inhalable steroids. The children who took higher doses were at an increased risk of stunted growth.

Children who use inhalable steroids for asthma grow slower than their peers in the first year of taking the medication, researchers say.

But doctors said the effect was so small it was easily outweighed by the clear benefits of taking the drugs, which prevent serious asthma attacks and even deaths from the breathing disorder.

Children who used the common corticosteroids to alleviate their asthma symptoms grew on average half a centimetre less over the course of a year, compared with children who did not take the medicine.

The steroids seemed to affect children’s growth only in the first year and had even less of an impact on their growth rate when used in low doses of no more than 100 micrograms.

Most people with asthma use inhalers that deliver a puff of salbutamol, a non-steroidal drug that quickly opens constricted airways. But around 80% will at some point take an inhalable steroid too, which works more slowly to reduce inflammation in the airways. Some 5.4 million people in Britain have asthma, with around a million being children.

The latest findings come from two studies byFrancine Ducharme, a paediatrician at the University of Montreal, and researchers at the Federal University of Rio Grande in Brazil, for the Cochrane collaboration, an organisation that publishes “gold standard” reviews of health care research.

For thefirst report, the researchers compiled evidence from 25 published trials of more than 8,400 children up to 18 years old. All had mild to moderate persistent asthma. From 14 trials that reported the figures, the average growth rate for children not taking steroids was six to nine centimetres a year. The range fell by half a centimetre in children who took any of six common corticosteroids used for treating asthma.

Thesecond review looked at 22 studies of children who took low (50 to 100 micrograms) or medium (200 microgram) doses of inhalable steroids. Only three trials followed children for a year or more. They found that those on the higher doses of steroids were most affected, growing around 20mm less in a year than children who took lower doses.

Ducharme said that the small number of studies that followed the effects on children for more than a year was a “major concern”, and recommended “that the minimal effective dose be used in children with asthma until further data on doses becomes available”.

Samantha Walker atAsthma UK said the use of inhalable of steroids has seen hospitalisations and deaths from asthma plummet, but that three people still died from attacks in Britain every day.

“Half a centimetre in growth is a small price to pay for medicine which may save your child’s life,” Walker said. “Uncontrolled asthma can substantially increase the likelihood of asthma attacks, hospitalisation and even death and we know that inhaled steroids, taken regularly, significantly reduce the likelihood of these events happening.”

Read the article from The Guardian here.

Check out the first and second studies.

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