The impact of asthma and its treatment on growth: an evidence-based review

Detalhes bibliográficos
Autor(a) principal: Zhang,Linjie
Data de Publicação: 2019
Outros Autores: Lasmar,Laura Belizario, Castro-Rodriguez,Jose A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal de Pediatria (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572019000300003
Resumo: Abstract Objectives: To assess the impact of asthma and its treatment (inhaled corticosteroids and other control medications) on growth. Data sources: The authors searched PubMed (up to August 24, 2018) and screened the reference lists of retrieved articles. Systematic reviews and meta-analysis were selected. If there was no such article, the authors selected either randomized clinical trials or observational studies. Data synthesis: A total of 37 articles were included in this review. The findings from 21 studies suggest that asthma per se, especially more severe and/or uncontrolled cases, can transitorily impair child's growth. Two Cochrane reviews of randomized clinical trials showed a small mean reduction in linear growth (-0.91 cm/year for beclomethasone, -0.59 cm/year for budesonide, and -0.39 cm/year for fluticasone) in the first year of treatment with inhaled corticosteroids in prepubertal children with persistent asthma. The effects were likely to be molecule- and dose-dependent. A recent review showed that most of "real-life" observational studies had not found significant effects of inhaled corticosteroids on growth in asthmatic children. Fifteen studies showed that the maintenance systemic corticosteroids could cause a dose-dependent growth suppression in children with severe asthma, but other controllers (cromones, montelukast, salmeterol, and theophylline) had no significant adverse effects no growth. Conclusions: Severe and/or uncontrolled asthma can transitorily impair child's growth. Regular use of inhaled corticosteroids may cause a small reduction in linear growth in children with asthma, but the well-established benefits of inhaled corticosteroids in controlling asthma outweigh the potential adverse effects on growth. Use of the minimally effective dose of inhaled corticosteroids and regular monitoring of child's height during inhaled corticosteroids therapy are recommended.
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spelling The impact of asthma and its treatment on growth: an evidence-based reviewAsthmaInhaled corticosteroidsLinear growthHeightAbstract Objectives: To assess the impact of asthma and its treatment (inhaled corticosteroids and other control medications) on growth. Data sources: The authors searched PubMed (up to August 24, 2018) and screened the reference lists of retrieved articles. Systematic reviews and meta-analysis were selected. If there was no such article, the authors selected either randomized clinical trials or observational studies. Data synthesis: A total of 37 articles were included in this review. The findings from 21 studies suggest that asthma per se, especially more severe and/or uncontrolled cases, can transitorily impair child's growth. Two Cochrane reviews of randomized clinical trials showed a small mean reduction in linear growth (-0.91 cm/year for beclomethasone, -0.59 cm/year for budesonide, and -0.39 cm/year for fluticasone) in the first year of treatment with inhaled corticosteroids in prepubertal children with persistent asthma. The effects were likely to be molecule- and dose-dependent. A recent review showed that most of "real-life" observational studies had not found significant effects of inhaled corticosteroids on growth in asthmatic children. Fifteen studies showed that the maintenance systemic corticosteroids could cause a dose-dependent growth suppression in children with severe asthma, but other controllers (cromones, montelukast, salmeterol, and theophylline) had no significant adverse effects no growth. Conclusions: Severe and/or uncontrolled asthma can transitorily impair child's growth. Regular use of inhaled corticosteroids may cause a small reduction in linear growth in children with asthma, but the well-established benefits of inhaled corticosteroids in controlling asthma outweigh the potential adverse effects on growth. Use of the minimally effective dose of inhaled corticosteroids and regular monitoring of child's height during inhaled corticosteroids therapy are recommended.Sociedade Brasileira de Pediatria2019-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572019000300003Jornal de Pediatria v.95 suppl.1 2019reponame:Jornal de Pediatria (Online)instname:Sociedade Brasileira de Pediatria (SBP)instacron:SBPE10.1016/j.jped.2018.10.005info:eu-repo/semantics/openAccessZhang,LinjieLasmar,Laura BelizarioCastro-Rodriguez,Jose A.eng2019-04-15T00:00:00Zoai:scielo:S0021-75572019000300003Revistahttp://www.jped.com.br/https://old.scielo.br/oai/scielo-oai.php||jped@jped.com.br1678-47820021-7557opendoar:2019-04-15T00:00Jornal de Pediatria (Online) - Sociedade Brasileira de Pediatria (SBP)false
dc.title.none.fl_str_mv The impact of asthma and its treatment on growth: an evidence-based review
title The impact of asthma and its treatment on growth: an evidence-based review
spellingShingle The impact of asthma and its treatment on growth: an evidence-based review
Zhang,Linjie
Asthma
Inhaled corticosteroids
Linear growth
Height
title_short The impact of asthma and its treatment on growth: an evidence-based review
title_full The impact of asthma and its treatment on growth: an evidence-based review
title_fullStr The impact of asthma and its treatment on growth: an evidence-based review
title_full_unstemmed The impact of asthma and its treatment on growth: an evidence-based review
title_sort The impact of asthma and its treatment on growth: an evidence-based review
author Zhang,Linjie
author_facet Zhang,Linjie
Lasmar,Laura Belizario
Castro-Rodriguez,Jose A.
author_role author
author2 Lasmar,Laura Belizario
Castro-Rodriguez,Jose A.
author2_role author
author
dc.contributor.author.fl_str_mv Zhang,Linjie
Lasmar,Laura Belizario
Castro-Rodriguez,Jose A.
dc.subject.por.fl_str_mv Asthma
Inhaled corticosteroids
Linear growth
Height
topic Asthma
Inhaled corticosteroids
Linear growth
Height
description Abstract Objectives: To assess the impact of asthma and its treatment (inhaled corticosteroids and other control medications) on growth. Data sources: The authors searched PubMed (up to August 24, 2018) and screened the reference lists of retrieved articles. Systematic reviews and meta-analysis were selected. If there was no such article, the authors selected either randomized clinical trials or observational studies. Data synthesis: A total of 37 articles were included in this review. The findings from 21 studies suggest that asthma per se, especially more severe and/or uncontrolled cases, can transitorily impair child's growth. Two Cochrane reviews of randomized clinical trials showed a small mean reduction in linear growth (-0.91 cm/year for beclomethasone, -0.59 cm/year for budesonide, and -0.39 cm/year for fluticasone) in the first year of treatment with inhaled corticosteroids in prepubertal children with persistent asthma. The effects were likely to be molecule- and dose-dependent. A recent review showed that most of "real-life" observational studies had not found significant effects of inhaled corticosteroids on growth in asthmatic children. Fifteen studies showed that the maintenance systemic corticosteroids could cause a dose-dependent growth suppression in children with severe asthma, but other controllers (cromones, montelukast, salmeterol, and theophylline) had no significant adverse effects no growth. Conclusions: Severe and/or uncontrolled asthma can transitorily impair child's growth. Regular use of inhaled corticosteroids may cause a small reduction in linear growth in children with asthma, but the well-established benefits of inhaled corticosteroids in controlling asthma outweigh the potential adverse effects on growth. Use of the minimally effective dose of inhaled corticosteroids and regular monitoring of child's height during inhaled corticosteroids therapy are recommended.
publishDate 2019
dc.date.none.fl_str_mv 2019-01-01
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1016/j.jped.2018.10.005
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Pediatria
publisher.none.fl_str_mv Sociedade Brasileira de Pediatria
dc.source.none.fl_str_mv Jornal de Pediatria v.95 suppl.1 2019
reponame:Jornal de Pediatria (Online)
instname:Sociedade Brasileira de Pediatria (SBP)
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reponame_str Jornal de Pediatria (Online)
collection Jornal de Pediatria (Online)
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