Asthma Treatment Does Not Stunt a Child's Growth
An estimated five million children in this country suffer from asthma, and a study in this morning's <em>New England Journal of Medicine</em> reports that contrary to the fears of many parents, the most effective drugs available will not stunt children's growth permanently. Dr. Soren Pedersen of the University of Odense in Denmark led the study, and he is here to tell us more.
Asthma is a respiratory ailment that can be triggered by a variety of irritants from pollution to common allergens to stress. It is the seventh-leading chronic condition in the nation, with more than 17 million sufferers. It is also the leading chronic illness in children in the US--affecting about 5.5 million a year, and it is the leading cause of school absenteeism due to chronic illness.
The number of Americans with asthma increased from 6.7 million in 1980 to 17.3 million 1998. Deaths due to asthma have more than tripled from 84 in 1977 to 280 in 1995. More than 200,000 children were hospitalized last year across the US for asthma related illnesses, and that number is expected to rise this year.
Doctors have known that in children with severe cases of asthma, the effectiveness of steroids outweighed any side effects. But they weren't sure whether that was true in mild cases. This study suggests that despite a short- term growth suppression in the first year of use, the change is not permanent.
Previously, inhaled corticosteroids were only available for kids as young as four years of age. But this August, the Food and Drug Administration approved a new inhaled corticosteroid called Pulimcort Respules that can be used on kids as young as one year old.
Interview with Dr. Pedersen
The potential for stunted growth has been the main concern about using these steroids. This study shows you can give children this drug for long periods of time without any problems, or concerns about side effects like growth suppression. It's not an issue anymore. ©MMII CBS Worldwide Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed
We determined that there was no significant relationship between steroid use and growth by measuring the children when they were fully-grown. It was the longest asthma study ever conducted. The children were tracked for 13 years. At the end of the study it was found they were all either as tall as their parents or taller, a good indicator that there was no long-term effect on growth.
Since it's long been known that these drugs are the best option when it comes to treating asthma, the significance of the study is that parents should not hesitate to allow the drugs to be prescribed. Concerns are especially high in the US about the effects of the drugs on growth, and this has resulted in modest use in this country. Given the study results, and since asthma is a potentially deadly disease, the drugs should be prescribed more widely. Parents should be more concerned about heir child's asthma than growth-related side effects.
The availability of a new inhaled corticosteroid for use on one-year-olds is particularly significant because an estimated 80% of children are diagnosed with asthma before age five. The other available steroids are only suitable for children as young as four years old. The new drug is important because in general, the earlier you treat asthma, the better results you get.
We don't know what causes asthma, but we know the number is increasing. Especially wherever you have "westernized" lifestyle, but it is not clear why.