[Inhaled corticosteroids and statural growth in asthmatic children]

ABSTRACT

By its anti-inflammatory effect on the bronchial mucous membrane, the use of inhaled corticoids [IC] had significantly improved medicosocial care of asthmatic patients. In paediatrics, the most important problem is about growth. The aim of this study is to evaluate the effect of prolonged IC on asthmatic's growth. This study was conducted in the Unit 2 of Casablanca Children Hospital. One hundred children followed for moderate or severe asthma and treated by high doses of IC [500 to 1500 micro/day] for a minimum of 1 year were enrolled in the study. Height of patients has been regularly monitored, in order to establish their growth velocity. Height has been measured in standard deviation [SD] and compared to the reference curves of Sempe and Pedron. Prescribed corticoid molecules were Budesonide, Fluticasone Monopropionate and Beclometasone Dipropionate. Average duration of treatment was 3.3 years [from 12 months to 9 years]. In 84% of children, the initial height varied between -1 and +1 SD. Growth velocity after one year of IC was reduced in 51% of cases. In 78 patients, growth velocity was normal. Height referred to age and gender was normal in 99% at the last checking. One case of height growth retardation [-45D] was reported in a child who had initial height at -2SD. this study shows that the impact of IC on height remains exceptional. Even if the growth velocity has been slowed down during the first year of treatment, most often it recovered afterwards without consequence on final height. These results seem in line with other studies. The benefits of IC among children far out weight the incurred risks