The impact of asthma and its treatment on growth: an evidence-based review
Journal Title: Jornal de Pediatria - Year 2019, Vol 95, Issue 0
Abstract
Objectives To assess the impact of asthma and its treatment (inhaled corticosteroids and other control medications) on growth. Data sources The authors searched PubMed (up to August 24, 2018) and screened the reference lists of retrieved articles. Systematic reviews and meta-analysis were selected. If there was no such article, the authors selected either randomized clinical trials or observational studies. Data synthesis A total of 37 articles were included in this review. The findings from 21 studies suggest that asthma per se, especially more severe and/or uncontrolled cases, can transitorily impair child's growth. Two Cochrane reviews of randomized clinical trials showed a small mean reduction in linear growth (−0.91cm/year for beclomethasone, −0.59cm/year for budesonide, and −0.39cm/year for fluticasone) in the first year of treatment with inhaled corticosteroids in prepubertal children with persistent asthma. The effects were likely to be molecule- and dose-dependent. A recent review showed that most of “real-life” observational studies had not found significant effects of inhaled corticosteroids on growth in asthmatic children. Fifteen studies showed that the maintenance systemic corticosteroids could cause a dose-dependent growth suppression in children with severe asthma, but other controllers (cromones, montelukast, salmeterol, and theophylline) had no significant adverse effects no growth. Conclusions Severe and/or uncontrolled asthma can transitorily impair child's growth. Regular use of inhaled corticosteroids may cause a small reduction in linear growth in children with asthma, but the well-established benefits of inhaled corticosteroids in controlling asthma outweigh the potential adverse effects on growth. Use of the minimally effective dose of inhaled corticosteroids and regular monitoring of child's height during inhaled corticosteroids therapy are recommended.
Authors and Affiliations
Linjie Zhang
Keywords
Related Articles
- EP ID EP497612
- DOI 10.1016/j.jped.2018.10.005
- Views 68
- Downloads 0
Parents’ perception of health-related quality of life in children and adolescents with excess weight
Objective To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception. Methods T...
Post-infectious bronchiolitis obliterans in children: is general quality of life the right measure?
In recent years, the long-term survival of many chronic progressive pulmonary diseases has improved; with such progress, the attention has also shifted from strictly focusing on physiological measurements of lung functio...
BH4 deficiency identified in a neonatal screening program for hyperphenylalaninemia
Objectives To show the general prevalence and to characterize tetrahydrobiopterin (BH4) deficiencies with hyperphenylalaninemia, identified by the Neonatal Screening Program of the State of Minas Gerais. Methods Descrip...
Critical assessment of the pH of children's soap
Objective To evaluate the pH value of children's antibacterial soaps and syndets used in children's baths and verify whether there is information regarding pH on the product label. Methods Quantitative, cross-sectional,...
IV fluid choices in children: have we found the solution?
There have been at least 15 randomized controlled trials (RCTs) published on the isotonic versus hypotonic maintenance fluid debate in the last decade, the most recent of which was the trial conducted by Valadão et al.,1...