Inhaled corticosteroids (ICS) are among the most significant treatment alternatives in stubborn asthma attributable to their effectiveness in restraining the inflammatory reaction. The medical gains of long-standing treatment with inhaled corticosteroids are constantly highlighted in national (the US and UK) and global directives. Nonetheless, in their study, Loke, Blanco, Thavarajah, and Wilson (2015) affirmed that there have been extensive, long-term issues concerning side effects (for instance, decreased growth in children and fractures) associated with ICS. The application of a randomized controlled trial for over one year in children who have asthma has some effect on yearly growth velocity.
Literature Review
Loke et al. (2015) hypothesized that the greatest area of concern and indecision is the potential for reduced growth velocity and height of children who have used ICS for a long time. The research by Loke et al. (2015) consulted a wide pool of recent peer-reviewed studies, which enhanced its credibility. Recent suggestions on comprehensive evaluations of side effects have recommended that a broad scope of research designs (beyond just randomized controlled trials) may be considered reliant on the aspects of the adverse outcome of a concern.
In their quantitative study, Loke et al. (2015) carried out a secondary method of data collection where they searched data in databases such as MEDLINE, EMBASE, and PubMed. They chose randomized controlled trials and observational studies of inhaled corticosteroids application in children with asthma. The results of the study established that the adult height of such children illustrated a mean decrease of 1.2 cm with budesonide against placebo in a first-rate randomized controlled trial. The study by Loke et al. (2015) is valuable not just to health professionals but also to parents as it is simple to understand.
Health professionals employ a stepwise mode of raising ICS dosage reliant on the severity and management of asthma (De Leonibus et al., 2016). ICS has been established to be successful in the reduction of the symptoms of asthma, lessening airway soreness, and minimizing the incidence and severity of aggravations. Similar to the affirmation by Loke et al. (2015), De Leonibus et al. (2016) asserts that though inhaled corticosteroids are successful in the management of asthma, they are linked to the suppression of growth. The inhibitory impact on growth is reliant on the dosage and is associated with the repression of bone development. Moreover, the influence of inhaled corticosteroids on linear growth is linked more powerfully with the IC molecule when compared to the absolute dosage.
De Leonibus et al. (2016) carried out a retrospective study on 113 children with asthma and 66 others who formed the control experiment. 113 children had mild-to-moderate asthma and used inhaled corticosteroids exclusively. Repeated measurements were done in conjunction with a general linear model to assess the influence of ICS, the period of treatment, and the cumulative dosage on final height (FH) corrected for numerous variables.
The results of the study established that at pre-puberty, the weight and height standard deviation scores were equal between the groups. However, the height standard deviation score increasingly reduced in the course of the study duration in children who had asthma (that is, from pre-puberty to FH). Though the study concluded that ICS influence pubertal growth and FH in children with asthma when judged against controls, it would have been more valuable if it had recommended the best treatment process that has minimal or no adverse effects.
Conclusion
Asthma denotes a chronic inflammatory infection of the airways whose commonest approach to treatment is the use of inhaled corticosteroids. Though ICS is successful in the treatment of asthma, they are linked to the inhibition of growth. There is a need for further studies to establish the most favorable treatment of asthma that has mild or no side effects.
References
De Leonibus, C., Attanasi, M., Roze, Z., Martin, B., Marcovecchio, M. L., Di Pillo, S.,… Mohn, A. (2016). Influence of inhaled corticosteroids on pubertal growth and final height in asthmatic children. Pediatric Allergy and Immunology, 27(5), 499-506.
Loke, Y. K., Blanco, P., Thavarajah, M., & Wilson, A. M. (2015). Impact of inhaled corticosteroids on growth in children with asthma: Systematic review and meta-analysis. PLoS One, 10(7), 1-11.