The Effect Of Inhaled Corticosteroids On The Growth Of Asthmatic Children:a Meta-Analysis

Objective:The safety of inhaled corticosteroids (ICS) for the therapy of asthma remains a topic of ongoing debate. We conducted the meta-analysis to evaluate whether ICS cause delayed growth velocity in asthmatic children.Methods:A systematic literature review was conducted. PubMed (Medline), Embase, The Cochrane Library (Central), CBM, Wanfang database (～3/2015) were searched for randomized controlled trials of ICS therapy in children with asthma that evaluated growth velocity. A preliminary database of 439 articles rendered 19 includable studies representing 4537 patients with asthma, which yielded 38 test results of the corticosteroid-growth effect.Results:Included trials (19 publications,38 results,4537 asthmatic children) were analyzed with subgroups by medication, duration of therapy, inhaled device, dosage, and age of participants. The meta-analysis of combined studies resulted the pooled standard mean weight of -0.42 (-0.53,-0.32) using random effects analysis and showed a decrease in growth velocity of ICS. The effect on growth velocity varied in different medication species. Meanwhile, ICS-growth effect was dose-related and correlation with duration of therapy.Conclusions:This meta-analysis suggested that ICS caused a decrease in growth velocity compared with non-ICS/placebo in mild to moderate asthmatic children. The potential effect on adult height still need further study. The goal should be controlling the asthma or wheezing efficiently with lowest dosage of ICS.