According to new research, long-term use of a form of medication commonly prescribed to treat symptoms of asthma – inhaled corticosteroids – could lead to a reduced rate of growth in development for infants given the medication during their first 2 years of life.
Researchers from the University of Eastern Finland and Kuopio University Hospital, also in Finland, analyzed the asthma medicine intake of children and the effect it had on their height and weight.
Their findings are to be presented at the 54th Annual European Society for Paediatric Endocrinology Meeting, held in Barcelona, Spain.
Inhaled corticosteroids are a form of medication used to prevent symptoms of asthma by preventing cells in the respiratory system from releasing certain symptom-causing substances.
Guidelines recommend that, among infants, inhaled corticosteroids are only used to treat recurrent wheezing. Singular or secondary cases of wheezing should be treated with short-acting bronchodilators or a short course of oral corticosteroids.
“However, inhaled corticosteroids have been used more loosely instead of the recommendations,” lead researcher Dr. Antti Saari told Medical News Today. “There has also been debate that obstruction under 1-2 years of age is not asthma and should never be treated with inhaled corticosteroids.”
According to the Centers for Disease Control and Prevention (CDC), around 6.8 million children in the US currently have asthma – around 9.3%. In 2012, around 5.4% of children aged 0-4 years had asthma.
“Previously, the impact of corticosteroids on growth was looked at in older children and was thought to alter growth only temporarily,” reports Dr. Saari. “However, studies on inhaled corticosteroid use in infants are practically lacking and thus this has been questioned in the recent study.”
For the study, the researchers looked at a population-based cohort of 6,391 boys and 6,091 girls. Data were obtained on their height and weight measurements alongside the heights of their parents and drug purchases from their birth until the age of 24 months.
The researchers then compared the data for infants exposed to the inhaled corticosteroids fluticasone and budesonide with data for the infants who did not receive this medication.
- An estimated 18.7 million adults in the US have asthma (around 8%)
- In the US, asthma is the primary diagnosis of 14.2 million visits to physician offices a year
- According to the CDC, boys are more likely to be diagnosed with asthma than girls.
Children who had used inhaled corticosteroids during the first 2 years of life were found to be shorter than expected for their age, with this finding more apparent among those who had used budesonide for longer than 6 months.
“Our research shows a link between long-term treatment of ICS [inhaled corticosteroids] during infancy and stunted growth at or after the age of 2 in otherwise healthy children,” Dr. Saari concludes.
Dr. Saari told MNT that there could be a possible bias in their results. “However, we have adjusted our results to the antibiotic exposure during infancy and I believe this reduces the possibility for bias,” he added.
In the long term, stunted growth during infancy can lead to individuals permanently losing growth potential, resulting in a shorter adult height than would have been expected.
The researchers state that their observations highlight the importance of appropriate use of inhaled corticosteroids in infants. As this medication is only available with a doctor’s prescription, the results suggest extra caution should be paid when looking to treat respiratory conditions such as asthma.
Going forward, the team aims to assess the impact of this medication in older children and over a longer period, as Dr. Saari explains:
“According to our research, we could only assess the impact of inhaled corticosteroids on growth in infancy until 2 to 3 years of age. The longitudinal impact of these medications is not clear and we would therefore like to investigate this further.”