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Inhaled Corticosteroids and Growth: Still an Issue after All These Years

“Growing up with asthma, vivid childhood memories include the rancid taste of daily potassium iodide expectorant, buzz of ephedrine inhalers and aminophylline, and emergency epinephrine injections administered by my pediatrician father. The issue about inhaled corticosteroids and growth, in some ways, comes down to this: Would I have traded all of that for more effective treatment that I knew might slow my growth and cost me 1 or 2 cm in eventual height?”

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Featured

 Inhaled Corticosteroids: Overview and Practice Questions

Inhaled corticosteroids are considered to be maintenance or controller medications and should not be administered during an acute episode. That is because they work to reduce airway inflammation rather than provide immediate bronchodilation.

Articles of Interest

A Review on the Safety and Efficacy of Inhaled Corticosteroids in the Management of Asthma

Inhaled corticosteroids (ICS) have been recommended as initial therapy in the treatment of persistent asthma in all guidelines, as they have been shown to reduce morbidity and mortality. However, high-dose regimens and long-term use of ICS may be associated with a variety of side effects, similar to those observed with systemic corticosteroid therapy.

Efficacy and Safety of Inhaled Corticosteroids New Developments

Inhaled corticosteroids have revolutionized the treatment of asthma and have now become the mainstay of therapy for patients with chronic disease.

Inhaled Corticosteroids

Inhaled corticosteroids (ICS, also known as glucocorticosteroids, glucocorticoids, steroids) are by far the most effective controllers used in the treatment of asthma and the only drugs that can effectively suppress the characteristic inflammation in asthmatic airways, even in very low doses. By contrast, ICS are largely ineffective in suppressing pulmonary inflammation in COPD and have a poor clinical effect. In both asthma and COPD ICS are commonly given as combination inhalers with long-acting β2-agonists (LABA).

Inhaled Corticosteroids: Past Lessons and Future Issues

However, although it was first thought that direct delivery might eliminate systemic adverse effects, this has not been confirmed by clinical trials and experience. Inhaled corticosteroids are absorbed from the lungs into the systemic circulation, in which they can acutely decrease growth velocity in children, an effect that fortunately appears to be temporary and might have no effect on final adult height.

Still confused after Flovent discontinuation? What to know and do

Now that Flovent is discontinued, is a generic product available? Yes, the drug manufacturer has licensed an authorized generic of both Flovent products: the metered-dose inhaler and the dry powder inhaler.

Resources

ICS List

From Qvar to Pulmicort...

StatPearls

Inhaled corticosteroids (ICS) are the FDA-indicated treatment of choice in preventing asthma exacerbation in patients with persistent asthma. Persistent asthma is classified by symptoms more than two days a week, more than three nighttime awakenings per month, more than twice a week using short-acting beta-2 agonists for symptom control, or any limitation of normal activity due to asthma.