A review of: The Childhood Asthma Management Program Research Group 2000 Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med 343:1054-1063 and Agertoft L, Pedersen S 2000 Effect of long-term treatment with inhaled budesonide on adult height in children with asthma. N Engl J Med 343:1064-1069.

WHEN INHALED GLUCOCORTICOSTEROIDS (IGCS) were introduced for asthma treatment in children a quarter of a century ago, they were used only by those with severe persistent disease, in whom they replaced oral glucocorticosteroids. Now, anti-inflammatory medications are recommended for use in any child whose asthma symptoms are not controlled by minimal use (≤2 times weekly) of an inhaled bronchodilator such as albuterol (1). Many parents of asthmatic children remain unconvinced that the benefits of IGCS are worth the risks. Some physicians share this view, citing prospective, randomized, double-blind, placebo-controlled studies which confirmed unequivocal benefits of beclomethasone dipropionate 400 μg daily on all asthma outcomes, but also revealed a growth delay of approximately 1 cm/year, evident within a few months of starting IGCS treatment (2, 3).

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