Children under 5 years of age who start treatment with inhaled corticosteroids for asthma are at risk of growth retardation, report Turkish researchers.

To evaluate the effects of fluticasone propionate on growth and adrenocortical function in young children, the researchers studied 20 asthmatic boys and girls over a period of 24 weeks.

The children, who ranged in age from 2.5 to 5 years, were taking fluticasone by a metered dose inhaler, four puffs (50 mg dose per puff) twice daily with a large volume spacer. They were matched by age to 18 non asthmatic children to provide a comparison.

The drug had little effect on adrenocortical function. But when the investigators compared individual pre and post treatment height, they noted no changes in the growth rates of half the children. However, while two of the children showed a significant increase in growth and two others a slight decrease, six children 30 per cent of the study group showed a significant growth reduction.

The long term effects of inhaled steroids on the final growth in children who take these drugs at a young age is not well studied. However, based on the findings of this small short term study, the growth rate of under 5s undergoing steroid therapy should be monitored closely (Ann Allergy Asthma Immunol, 2001; 86: 649-54).