No dose effect observed with chronic fluticasone propionate on growth velocity in children.

Inhaled corticosteroid (ICS) therapy is recommended for most children with asthma irrespective of severity. Although this risks growth suppression, the benefit/risk profile is considered favorable.1,2 The effects of ICS on growth have mainly been evaluated in placebo-controlled trials; other controls used include nedocromil, montelukast, and sodium cromoglicate. Given the established role of ICS in treating asthma, it would not be ethical to enroll patients with moderate-severe asthma into a study where they may be randomized to non-ICS therapy. Therefore, much of the data characterizing the growth-suppressive effects of ICS comes from children with mild-moderate asthma.