© 2004 BMJ Publishing Group & Royal College of Paediatrics and Child Health
PERSPECTIVE
Asthma
The use of inhaled corticosteroids during childhood: plus ça change...
Correspondence to:
Correspondence to:
Dr G Russell
Royal Aberdeen Children’s Hospital, Cornhill Road, Aberdeen AB25 2ZD, UK; libra@ifb.co.uk
Commentary on the paper by Masoli et al (see page 902)
| The first 150 words of the full text of this article appear below. |
Inhaled corticosteroid therapy (ICT) has a long and for the most part honourable history in the management of asthma. Introduced in an attempt to minimise the side effects associated with systemic treatment, early trials with nebulised hydrocortisone showed little if any added benefit,1 but with the introduction of beclomethasone dipropionate,2 ICT rapidly assumed a central rôle in the management of asthma, transforming the lives of millions of sufferers.
Early studies were reassuring, but it soon became apparent that ICT did have measurable systemic effects on the hypothalamo-pituitary-adrenal axis,3 although there was little evidence that these translated into clinically significant problems, overt corticosteroid toxicity being a rare and apparently idiosyncratic reaction.4 Worries about the very real effects of ICT on growth5 have been largely banished by the demonstration of normal adult height at follow up.6 Posterior subcapsular cataract formation has been reported in children on ICT, but mainly in children
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