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Inhaled steroid therapy for childhood asthma reduces final height by just over a centimetre according to the results of a multicentre US trial (N Engl J Med 2012;367:904–12) and this height is lost in the first 2 years of treatment. Adult height was measured in 943 of the 1041 participants enrolled into the Childhood Asthma Management Program trial in 1993–1995. At the age of 5–13 years children with mild or moderate asthma had been randomised to inhaled budesonide 200 μg twice daily, inhaled nedocromil 8 mg twice daily, or placebo, for 4–6 years. After adjustment, final height was 171.1 cm (budesonide), 172.1 cm (nedocromil), and 172.3 cm (placebo. The loss of final height with budesonide compared with placebo (1.2 cm) was similar to that seen after 2 years of treatment (1.3 cm) and varied with budesonide dose (0.1 cm loss of final height for every microgram per kilogram of body weight increase in daily dose over the first 2 years of treatment). Inhaled steroid slows growth in height in the first few years after beginning treatment but growth at a normal rate is then resumed.
There is concern about the duration of protection provided by the acellular pertussis vaccine. Children in …