Budesonide, an anti-inflammatory steroid found in Rhinocort and Pulmicort, has been used for decades to treat asthma. But, like all steroids, it has side effects. Over 10 years ago, researchers noted that children taking the drug were about half an inch shorter than children on other treatments. Now, a study just published in the New England Journal of Medicine has found that this effect may be permanent.
For this study, a research team led by Dr. William Kelly of the University of New Mexico tracked down 943 of the 1,000 children from the original investigation; at the time, all were aged five to 12 and received either budesonide, a non-steroid drug, a placebo, or a sham treatment. Now, over a decade later, the children who were given budesonide were still, on average, about half an inch shorter than their peers.
Since the benefits of budesonide for sufferers of serious asthma have been well established, the researchers point out that the potential loss of half an inch of height must be balanced against the corticosteroid s effective management of persistent asthma. The researchers did find that the growth-stunting effect does not worsen over time; the average of half an inch did not appear to increase as the children grew into adults. It s also worth noting that the effect may be somewhat mitigated by halving the typical 400 microgram dose: Studies have demonstrated that at this smaller dose the drug remains effective while the children involved are, on average, a little less than half an inch shorter than children getting different treatments.
As Dr. Bloom notes, There are always trade-offs when using a steroidal medication, especially when it's used chronically. It s a serious medication for a serious problem. Any doctor treating an asthmatic child will be monitoring lung function and prescribing the lowest effective dose possible. That said, prophylactic asthma therapy has come a long way in controlling the disease. These drugs work very well.