Effect of Inhaled and Intranasal Corticosteroids on Growth

Abstract

ABSTRACT

Objective:

This review will enable the reader to discuss effects of inhaled and intranasal corticosteroids on linear growth.

Data sources:

MEDLINE (PubMed) search using terms growth, corticosteroid, asthma, and cross referencing of related articles published in the English language and restricted to humans, especially within the past 10 years.

Results:

Evaluations of effects of adrenal corticosteroids on growth are complicated by wide variations in saltatory growth and ages of onset of puberty and delays in puberty that may be associated with asthma. Asthmatic children, however, usually attain normal height ultimately. Inhaled beclomethasone dipropionate, 84 μg qid to 200 μg bid over 1 year can cause at least temporary reductions in growth of 1–1.4 cm as compared with asthmatic children receiving placebo. Fluticasone propionate, 50 μg or 100 μg bid for 1 year has not caused significant growth suppression. Nebulized budesonide, 0.25–1 mg daily for 1 year has caused a mean reduction in growth of 0.8 cm in children 5 months to 107 months of age. Limited data indicate growth suppression with intranasal beclomethasone, 168 μg bid, but none with intranasal mometasone, 100 μg daily.

Conclusion:

Potential temporary inhibition of growth by inhaled or intranasal corticosteroids especially in prepubertal children should be considered when comparing potential risks and benefits. Pharmacotherapy should not be a substitute for allergen avoidance or appropriate immunotherapy.