Expert: Marc Rubin, RPh Asthma Educator - 1/31/2008

Question
Hi Marc,

I understand that use of inhaled steroids to treat childhood asthma can cause a slight reduction in growth velocity for the first year of use, with the adult height of the patient unaffected.

However, would intermittent use of inhaled steroids (for example, one year on, one year off) cause repeated dips in growth and compromise final adult height?

Thanks for your time,

From Marc

Answer
There have not been controlled studies to look at that, since, if the patient has asthma that is persistent (not seasonal, for example) you would not want to compromise their health. The extent of growth suppression is dose related, and most cases do not require the highest dosage levels. In addition, you also have a situation where poorly controlled asthma, resulting in chronic illness, can lead to a poorer nutritional state, also leading to less height growth. The typical loss in stature is approximately 1 cm, not something that would be of note. What is important,presently, inhaled steroids are the gold standard of treatment for the majority of patients with persistent asthma. Granted, not all patients respond to this therapy, but by not controlling the inflammation in the lungs, we put the patient at greater risk of an acute attack which may result in death.

Research today is very dynamic. Searching to examine why there are variations in response to the present medications, seemingly due to genetic variation, is one of the issues at the forefront. What tomorrow brings, we can only look towards.