Clinical Study On The Effect Of Long-Term Inhaled Corticosteroids At Low-Dose On Height In Asthmatic Children

Objective:To investigate the effect of long-term inhalation of corticosteroids at low dose on the height of asthmatic children,and provides further evidence for the safety of clinical medication in asthmatic children.Methods: 133 asthmatic children who had diagnosed in the pediatric department of the first affiliated hospital of Guangxi Medical University from June2005 through September 2019 were enrolled into thisretrospectivestudy.Patientswere prescribed low-dose ICS for at least 12 months,followed up regularly and with symptoms well controlled,including 76 patients who had ICS discontinued and 57 patients who continue daily ICS.The76 asthmatic children who had stopped taking medicine were investigated by the uniformquestionnaire of the national cooperative asthma group.The main endpoints were gender,origin(urban or rural areas),age of ICS discontinuation,ICS,daily dose,therapeutic course,height of ICS discontinuation and before 1year.The age and height at the point of the last follow-up were recorded in 25 patients of them.Gender,origin(urban or rural areas),age,ICS,daily dose,therapeutic course,heightat last visited and before 1 yearwere recorded in 57 patients.251 children without the history of corticosteroid use and chronic diseases that might affect height were recruited as control group,whom gender-,origin-,and age-matched to asthma groups.Theirheight were measured and recordedby trained personnel.Results:1.Demographic characteristics: Asthmatic children including 103 boys and 30 girls,66 were urban and 67 were rural,while the control including180 boys and 71 girls,123 were urban and 128 were rural.Patients have aged2-18 years and a median of 8 years.Children were ranged in age from 2 to 18,and a median of 9 years in the control group.Gender,origin,and age were similarbetween the two groups(P=0.22,P=0.90,P=0.29).2.Subgroup analysis of ICS discontinuation2.1The height of 76 asthmatic children was 133.7±22.8cm at the timing of ICS discontinuation,and that in the control group was 136.7±23.4cm.No difference was found between them(P=0.32);2.2 The height of 25 asthmatic children who continued to follow up had no differences with control groups according to the age(≤9 years,>9 years)(P=0.55,P=0.34)and the therapeuticcourse(<2 years,2-5 years,>5 years)(P=0.90,P=0.65,P=0.65).3.The final height of all asthmatic children in the observation group was136.1±22.2cm,and that in the control group was 136.7±23.4cm.No difference was found between the whole patients and the whole control children(P=0.80).4.Subgroup analysis by age: The height of the 77 patients(≤9 years)was120.2±11.1cm,while the height of the 130 children without asthma at the same age was 117.7±13.1cm.The height of the 56 patients(>9 years)was157.1±13.4cm,while the height of the 59 childrenwithout asthma at the same age was 157.9±12.0cm.No differences were found in height of patients when compared with control groups respectively(P=0.16,P=0.68).5.Subgroup analysis by therapeuticcourse: The whole patients were divided into observation groups according to thetherapeuticcourse.The height of the55patients(≤2 years),54 patients(2-5 years),and 24 patients(>5 years)were124.1±17.9cm,139.1±21.2cm,and 156.8±15.3cm.The height ofchildrenwithout asthma at the same age and gender were 122.3±17.5cm,139.6±22.1cm,and154.8±13.3cm.No differences were found in height ofobservation groups when compared with control groups respectively(P=0.58,P=0.90,P=0.60).6.Subgroup analysis in growth velocity by therapeutic course: 85 asthmatic children who were recorded the height of 1 year before were divided into growth groups according to therapeutic course: ≤2 years,2-5 years,and >5 years.The growth velocity of them were 7.7±2.4cm,6.89±2.28 cm,and 6.58±2.52 cm.No differences were found in growth velocity among them when comparing respectively(P=0.15,P=0.11,P=0.67).7.Subgroup analysis byaverage daily dose of ICS: The asthmatic children were divided into observation groups according to average daily does:≤100μg/d,or 100-200μg/d.The height of them were 138.5±26.4cm and135.8±20.6cm.Children with same ages and gender were selected from the control group,and the height of them were 136.5±25.6cm and 135.6±15.3cm.No differences were found in height of observation groups when compared with control groups respectively(P=0.74,P=0.93).Conclusion:This retrospective study did not find that long-term inhalation of corticosteroids at low dose had an effect on the height of asthmatic children.