Children taking inhaled steroid drugs for asthma end up being slightly shorter as adults than those not using the medication, say researchers.

On average, children on steroids for asthma were half an inch shorter than their peers according to a study in the New England Journal of Medicine. 

It is the first major study to follow children with asthma into adulthood for height checks, though there have long been suspected links between steroid use and growth. 

However, Professor Robert Strunk, who lead the research also pointed out that "steroids can be lifesaving and untreated asthma can also lead to poor growth".

The study findings were presented at the European Respiratory Society meeting in Vienna, Austria [3 Sep] and involved more than 1,000 children aged 5-12 who were treated for mild to moderate asthma for four years as part of a U.S. clinical trial.

Splitting participants into three groups, one taking an inhaled corticosteroid, another an inhaled non-steroid while the final group received a placebo.

The average adult height was about one-half inch shorter in the group that received the inhaled corticosteroid (budesonide) than in those taking the steroid (nedocromil) or placebo.

However, the slower growth took place only in the first two years of the four-year study and as time progressed, the children who took the budesonide remained one-half inch shorter through adulthood than the children who did not use the drug.

Prof Strunk, a Professor of Pediatrics at Washington University School of Medicine in St Louis, said: "This was surprising because in previous studies, we found that the slower growth would be temporary, not affecting adult height.

"But none of those studies followed patients from the time they entered the study until they had reached adult height."

The researchers considered other factors that might have affected growth, including gender, age at the time the child entered the trial, how long the child had had asthma, as well as ethnicity, severity of asthma and reactivity to a skin test for allergies.

Prof Strunk concluded that physicians should monitor the progress of children with asthma to check for side effects from steroids but "the half-inch of lowered adult height must be balanced against the well-established benefit of inhaled corticosteroids in controlling persistent asthma".

Inhaled corticosteroids are widely considered the most effective form of anti-inflammatory treatment for asthma, which affects one in seven children in Britain.

Malayka Rahman, research analysis and communications officer at Asthma UK, said: "We know that some people with asthma don't always take their medicines as prescribed because they are concerned about the side effects of their medication.

"Inhaled corticosteroids are highly effective in the treatment of asthma and can save lives. So it is crucial to remember the benefits of taking inhaled steroids and these often far outweigh the costs."

Posted 05/09/2012 by richard.hook@pavpub.com