Corticosteroids and Growth Relation

Table of Contents

Introduction

Asthma, like many other respiratory diseases, is often treated with corticosteroids. The inhaled type of this medication is considered the most effective as compared to other forms. However, while the adult organism has a developed defense system against the external drug threat, children are subject to various side effects that are caused by corticosteroids. One of the major issues related to the use of this medication type among children is the effect on their growth. The literature review offers an insight into this problem and claims that children treated with inhaled corticosteroids grow less than their peers who do not undergo this procedure.

Literature Review

Two articles were chosen to study the effect of corticosteroids on child growth. Both of them rely on previous studies and operate with secondary information. The first article includes a short statement of findings and a reference list, while the second one features several tables explaining the research process in detail.

Article I

The article posted as part of Paediatric Respiratory Reviews begins with stating the purpose of the study, which is to measure the effect of increasing the dose of inhaled corticosteroids (ICS) among children with asthma. The idea was to collect the research articles that discussed the difference in growth among the tested children aged 1-17 years old. The important point was to find articles that used different doses as the study base. The findings were later compared and conclusions made on whether the amount of ICS medication resulted in the growth difference among the studied groups.

There are several strong sides of the research. Firstly, a total of 728 school children was tested on the subject, which is an adequate number. Secondly, the length of each experiment was long enough to draw accurate conclusions. Finally, there were three different types of ICS, which helped to eliminate the wrong conclusions based on the choice of inappropriate medication. However, some features could affect the results of the study. For instance, it is mentioned that the research was conducted on the base of “three industry-funded trials” (Pruteanu, Chauhan, Zhang, Prietsch, & Ducharme, 2015, p. 51). This fact could cause results that would be beneficial for pharmaceutical companies.

Article II

This article serves as the background for the previous one. However, while the first article discussed whether the change in ICS dose leads to the difference in growth rate, this study focuses on the overall effect done by this medication on children’s development. The main result of the study claims that “regular use of ICS at low or medium daily doses is associated with a mean reduction of 0,48 cm/y in linear growth velocity” (Zhang, Prietsch, & Ducharme, 2014, p. 2).

A large portion of the article is dedicated to calculating the potential level of bias. It is noted that the highest possibility of bias came from the incomplete outcome data, along with the blinding of participants and personnel, and outcome assessment. Nevertheless, the study shows that even the small amount of ICS influences child growth.

Conclusion

Both articles present evidence that the use of ICS among children limits their linear growth compared to their peers who are not treated with this medication. Each article has considerations about possible limitations of the study featuring the participation of pharmaceutical companies and the issue of incomplete data. The major implication that can be derived from these articles is the support of the theory that ICS should be used as little as possible among children.

References

Pruteanu, A. I., Chauhan. B. F., Zhang, L., Prietsch, S. O., & Ducharme, F. M. (2015). Inhaled corticosteroids in children with persistent asthma: Is there a dose-response impact on growth? – An overview of Cochrane reviews. Paediatric Respiratory Reviews, 16(1), 51-52.

Zhang, L., Prietsch, S. O., & Ducharme, F. M. (2014). Inhaled corticosteroids in children with persistent asthma: Effects on growth. Evidence-Based Child Health, 9(4), 829-930.

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