Effect of long-term treatment with inhaled budesonide on adult height in children with asthma

N Engl J Med. 2000 Oct 12;343(15):1064-9. doi: 10.1056/NEJM200010123431502.

Abstract

Background: Short-term studies have shown that inhaled corticosteroids may reduce the growth of children with asthma. However, the effect of long-term treatment on adult height is uncertain.

Methods: We conducted a prospective study in children with asthma to examine the effect of long-term treatment with inhaled budesonide on adult height. We report on 211 children who have attained adult height: 142 budesonide-treated children with asthma, 18 control patients with asthma who have never received inhaled corticosteroids, and 51 healthy siblings of patients in the budesonide group, who also served as controls.

Results: The children in the budesonide group attained adult height after a mean of 9.2 years of budesonide treatment (range, 3 to 13) at a mean daily dose of 412 microg (range, 110 to 877). The mean cumulative dose of budesonide was 1.35 g (range, 0.41 to 3.99). The mean differences between the measured and target adult heights were +0.3 cm (95 percent confidence interval, -0.6 to + 1.2) for the budesonide-treated children, -0.2 cm (95 percent confidence interval, -2.4 to +2.1) for the control children with asthma, and +0.9 cm (95 percent confidence interval, -0.4 to +2.2) for the healthy siblings. The adult height depended significantly (P<0.001) on the child's height before budesonide treatment. Although growth rates were significantly reduced during the first years of budesonide treatment, these changes in growth rate were not significantly associated with adult height.

Conclusions: Children with asthma who have received long-term treatment with budesonide attain normal adult height.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adult
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Body Height / drug effects*
  • Budesonide / pharmacology*
  • Budesonide / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Glucocorticoids / pharmacology*
  • Glucocorticoids / therapeutic use
  • Growth / drug effects*
  • Humans
  • Male
  • Prospective Studies

Substances

  • Glucocorticoids
  • Budesonide