Inhaled Steroids for Asthma May Stunt Growth

Inhaled steroids, such as Rhinocort and Pulmicort (budesonide), which are typically prescribed for asthma treatment, may permanently stunt growth in children, according to a new study. Asthma affects some six million children and millions more adults in the U.S., said NBC News.

Although the growth stunting does not exacerbate with time, the popular drugs reduce growth in children by about a-half inch, and the effect is permanent, NBC News noted. The research appears in the New England Journal of Medicine; the study was presented at the European Respiratory Society Annual Congress in Vienna, Austria.

According to the research, physicians should collaborate with parents to reduce dosage as much as possible to minimize the stunting effect. Because drugs such as Rhinocort and Pulmicort are very effective in controlling serious asthma, the researchers do not recommend taking children off of the drugs if deemed necessary, said NBC News.

A large study conducted over a decade prior revealed that budesonide was safe and very effective; however, physicians did note at the time that the children in the study were approximately one-half inch shorter if treated with budesonide when compared to other treatments for asthma, NBC News wrote. “This was surprising because in previous studies, we found that the slower growth would be temporary, not affecting adult height,” said Dr. Robert Strunk of Washington University in St. Louis; Dr. Strunk worked on the study. “It clarifies that they do not eventually catch up as they age or fall further behind their peers,” added Dr. Gary Gibbons, director of the National Heart, Lung and Blood Institute, NBC News wrote.

The study involved more than 1,000 children aged 5 to 12 who took either budesonide, a non-steroid drug called nedocromil, or a placebo, said NBC News. William Kelly of the University of New Mexico and colleagues located 943 of the original children, now adults, and found that those who received budesonide remained, on average, about half an inch shorter than the other patients involved in the study.

For the study, the children received a dose of 400 micrograms, said NBC News. More recent studies have found that, although physicians can decrease this does by half, still controlling asthma, children taking even the lower dose are still under a half-inch shorter that children receiving different treatment. “This suggests that finding the minimum dose required to control each child’s asthma could help mitigate any potential effects on height,” Kelly said in a statement.

We previously wrote that patients with asthma and chronic obstructive pulmonary disease (COPD) who are treated with inhaled corticosteroids such as Flonase, Advair, Pulmicort, Rhinocort, QVAR, and Becloven may experience a significantly higher risk for developing diabetes. If they have diabetes, exacerbation of the disease can be expected, according to a Canadian study that looked at over 380,000 respiratory patients in Quebec.

The research revealed that use of the medications was linked to a 34 percent increase in the rate of new diabetes diagnoses and diabetes progression. For patients treated with higher dose inhalers, there was an increased diabetes risk with a 64 percent increase in diabetes onset and a 54 percent increase in the disease’s progression. “High doses of inhaled corticosteroids commonly used in patients with COPD are associated with an increase in the risk of requiring treatment for diabetes and of having to intensify therapy to include insulin,” the study team noted in a news release. During the study timeframe, about 2,100 patients diagnosed with diabetes prior to inhaler use saw progression of their diabetes that led to their having to increase their care from pills to insulin injections.

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