Certain asthma medications may slightly restrict children's growth, but the effect is small compared to the benefits of the drugs, according to new research.
Researchers examined information from 25 studies involving more than 8,000 children with frequent asthma symptoms who either took daily doses of medications known as inhaled corticosteroids, or who took nonsteroidal medications or a placebo.
On average, the children grew 2.4 to 3.5 inches (6 to 9 centimeters) over one year, but those who took inhaled corticosteroids grew about 0.2 inches (0.5 cm) less during the year than those who took a placebo or nonsteroidal medications, according to the review, which is published today (July 16) in the journal The Cochrane Library. [ 11 Surprising Facts About the Immune System ]
The effect on growth was strongest during the first year of treatment, and it was less pronounced in subsequent years, the researchers said.
Just one trial followed children who were treated with inhaled corticosteroids into adulthood, and that study found that those who took the drug daily for about four years were 0.5 inches (1.2 cm) shorter, on average, than those who took a placebo.
However, this effect "seems minor compared to the known benefits of the drugs for controlling asthma and ensuring full lung growth," study researcher Linjie Zhang, of the Federal University of Rio Grande in Brazil, said in a statement. Studies have shown that the drugs help reduce the severity of asthma attacks, as well as the number of asthma-related hospital visits and asthma-related deaths, the researchers said. However, the drugs can also inhibit the secretion of growth hormone, and in 1998, the U.S. Food and Drug Administration said that inhaled corticosteroids should carry warning labels about their potential to slow growth.
In a second review, also published today in The Cochrane Library, researchers found that lower doses of inhaled corticosteroids have less of an effect on growth than higher doses. Children in the studies taking lower doses (about one less puff per day) grew 0.1 inches (0.2 cm) more over a year on average than those who took higher doses.
The researchers recommended that children with asthma take the lowest dose of inhaled corticosteroids that is still effective, until further research looks into the effect of the drugs on growth.
There are currently seven different types of inhaled corticosteroids, and future studies should look at whether some of these affect children's growth more than others. In addition, studies included in the review often did not rigorously document children's growth for a full year, so future studies should better document growth, the researchers said.