Effect of Inhaled Corticosteroids on Long-Term Growth in Pediatric Patients with Asthma and Allergic Rhinitis

Objective: To evaluate the effect of orally and nasally inhaled corticosteroids (ICS) on final adult height in pediatric patients with mild to moderate persistent asthma and allergic rhinitis. Data Sources: MEDLINE (1975–April 2013), Cochrane Library (through 2012), and International Pharmaceutical Abstracts (1975–April 2013) were searched for prospective clinical trials assessing the effects of orally or intranasally ICS use on growth in pediatric patients with asthma or allergic rhinitis using the terms inhaled/intranasal corticosteroid, linear growth, height, and asthma or allergic rhinitis. Study Selection and Data Extraction: Eligible articles included double-blind, randomized, placebo-controlled studies of at least 1 year with growth velocity or height as the primary outcome. Data Synthesis: Seven trials and 1 follow-up study analyzing the effects of orally ICSs were examined. Of these studies, 4 found a delay in growth in at least 1 subset of its participants of approximately 1 cm, 1 study found a ...