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PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1813-1814

COMMENTARY

Is It Time to Reduce Our Phobia of Inhaled Corticosteroids?

Sami L. Bahna, MD, DrPH

Department of Pediatrics
Allergy/Immunology Section
Louisiana State University Health Sciences Center
Shreveport, LA 71130-9323

Abbreviations: ICS, inhaled corticosteroid • HPA, hypothalamic-pituitary-adrenal

The first 20% of the full text of this article appears below.

As inflammation became recognized as a major component of the pathology of asthma, inhaled corticosteroid (ICS) evolved as the cornerstone for pharmacologic control of the disease. The reward was reduction in asthma morbidity and mortality.1 Nevertheless, pediatricians maintained a concern about the effect of long-term use on growth. Conflicting findings were reported by studies that differed in one or more aspects, eg, the study design, patients’ age, initial severity of asthma, concomitant use of other medications, and degree of asthma control. Even more important is the ICS pharmacologic properties: dose, duration, and delivery system. It is important also to consider the method of assessing the potential adverse effects of ICS. Should the concern be about the growth velocity or the ultimate adult height? The ultracritical investigator may even be concerned about the hypothalamic-pituitary-adrenal (HPA) axis function.

. . . [Full Text of this Article]

Address correspondence to Sami L. Bahna, MD, DrPH, Department of Pediatrics, Louisiana State University Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71130-9323. E-mail: sbahna@lsuhsc.edu