NurseWeek

Children grow despite asthma medication

By Astara March
Health24News
October 13, 2000


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Washington (H24N). Parents of children with asthma who have worried that their child's growth might be stunted by using inhaled steroids may breathe easier now too.

A five-year study done at the National Heart, Lung, and Blood Institute (NHLBI), published in the Oct. 12 issue of The New England Journal of Medicine, has shown that the inhaled steroid budesonide caused a maximum 3/8 inch reduction in growth in the first year of treatment only. During the subsequent four years of the study, growth rates matched those of the untreated control group. The patients in the NHLBI study ranged from 5 to 12 years of age.

A second study done at two Danish Hospitals, reported in the same issue of The New England Journal of Medicine, followed children for 10 years through their adolescent growth spurt. These children also used budesonide for many years, but attained full average adult height.

In a public statement, Claude Lenfant, MD, director of the NHLBI, said, "We recognize that even a slight slowing of growth may be a concern for parents. But this effect was short term and temporary-after the first year, the growth rates were the same in all groups. And there are substantial long-term benefits of enabling a child with asthma to be active at play and school, to sleep through the night and to stay away from the emergency department and hospital."

The NHLBI study investigated the effects of budesonide, nedocromil (a non-steroidal anti-inflammatory medication), and placebo. A total of 1,041 children were randomized to one of the three drugs and followed for four to six years. Budesonide was significantly better than nedocromil at reducing urgent care visits, hospitalizations and the need for oral steroids, which are used to treat severe asthma attacks. In addition, children on budesonide had fewer days in which additional asthma medication was needed, and more days with no episodes of asthma than children taking either nedocromil or the placebo.

Although budesonide reduced lung inflammation, neither it nor nedocromil increased lung function.

The NHLBI investigators next plan to study children 5 and under to determine if earlier treatment will increase lung growth and halt lung function decline.

There are 5 million children with asthma in the United States, and asthma is the most chronic respiratory disease of childhood throughout the world.