Impact of Inhaled Corticosteroids on Growth in Children with Asthma: Systematic Review and Meta-AnalysisReportar como inadecuado

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Long-term inhaled corticosteroids ICS may reduce growth velocity and final height of children with asthma. We aimed to evaluate the association between ICS use of >12 months and growth.


We initially searched MEDLINE and EMBASE in July 2013, followed by a PubMed search updated to December 2014. We selected RCTs and controlled observational studies of ICS use in patients with asthma. We conducted random effects meta-analysis of mean differences in growth velocity cm-year or final height cm between groups. Heterogeneity was assessed using the I2 statistic.


We found 23 relevant studies twenty RCTs and three observational studies after screening 1882 hits. Meta-analysis of 16 RCTs showed that ICS use significantly reduced growth velocity at one year follow-up mean difference -0.48 cm-year 95% CI -0.66 to -0.29. There was evidence of a dose-response effect in three RCTs. Final adult height showed a mean reduction of -1.20 cm 95% CI -1.90 cm to -0.50 cm with budesonide versus placebo in a high quality RCT. Meta-analysis of two lower quality observational studies revealed uncertainty in the association between ICS use and final adult height, pooled mean difference -0.85 cm 95% CI -3.35 to 1.65.


Use of ICS for >12 months in children with asthma has a limited impact on annual growth velocity. In ICS users, there is a slight reduction of about a centimeter in final adult height, which when interpreted in the context of average adult height in England 175 cm for men and 161 cm for women, represents a 0.7% reduction compared to non-ICS users.

Autor: Yoon Kong Loke , Patricia Blanco, Menaka Thavarajah, Andrew M. Wilson



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