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The effect of asthma and its treatment on growth
  1. I J M Doull
  1. Correspondence to:
    Dr I J M Doull
    Cystic Fibrosis/Respiratory Unit, Department of Child Health, University Hospital of Wales, Cardiff CF14 4XW, UK;


Asthma has little, if any, significant effect on attained adult height. Untreated asthma results in a delay of puberty by approximately 1.3 years, and pubertal delay is likely to explain the majority of apparent growth failure in asthmatics. All currently available inhaled corticosteroids (ICS) result in growth suppression at conventional doses (400 μg/day of beclomethasone dipropionate equivalent), but the growth suppressive effects are relatively short lived, after which growth reverts to pretreatment levels. Younger, prepubertal children, appear more sensitive to the growth suppressive effects of ICS. Asthmatic children receiving conventional doses of ICS (400 μg/day of BDP equivalent) will attain an adult height indistinguishable from their predicted adult height (based on their mid parental height), and no different from non-asthmatics. Adult height could possibly be decreased in severe asthmatics, but this is unlikely to be greater than a 1.2 cm decrement. Recent longitudinal studies offer reassurance that at conventional doses ICS do not have significant long term effects on growth, and that their benefits consistently outweigh their side effects.

  • BDP, beclomethasone dipropionate
  • BUD, budesonide
  • FP, fluticasone propionate
  • ICS, inhaled corticosteroids

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  • Competing interests: The author has received financial support to attend meetings and given advice to Astra-Zeneca, Glaxo-Smith-Kline, Merck Sharpe and Dohme, and Schering-Plough