Up to 8.4% of pregnant women may be affected by asthma, which, if uncontrolled, can lead to adverse perinatal outcomes. Although National Asthma Education and Prevention Program Guidelines recommend the use of ICSs for the treatment of all severities of persistent asthma during pregnancy, few studies have assessed the safety of ICSs in pregnant women. [...]
Systemic corticosteroid use is a documented risk factor for the development of cataracts, but pediatric and adult study data argue against a large effect of ICS use on cataract development. In children, analysis of data from the CAMP study demonstrated the presence of one posterior subcapsular cataract among 311 children who received inhaled budesonide medication, [...]
The hypothalamic pituitary adrenal (HPA) axis is very sensitive to the systemic activity of corticosteroids and is thus a useful indicator of systemic activity of ICSs; however, the clinical relevance of minor changes in the HPA axis is unclear. A decrease in endogenous Cortisol production is expected, with systemic exposure to exogenous corticosteroids due to [...]
In general, low-to-medium-dose ICSs do not have significant effects on bone mineral density in children. No statistically significant differences in measurements of BMD were found in a study of children aged 4-17 years with asthma who had been treated with beclomethasone (300-800 (ig/day) for a mean duration of 25 months compared with children with asthma [...]
Growth
Studies assessing the effects of ICSs on growth in children for relatively short periods (< 1 year) have reported variable effects. In a 12-month, randomized, double-blind study, children aged 6-16 years with asthma who received beclomethasone dipropi-onate 84 jug four times daily experienced slower growth velocity (4.2 cm/year) compared with children given theophylline twice daily [...]
OBJECTIVES
After reading this article, “Safety of Inhaled Corticosteroids in the Treatment of Persistent Asthma,” the learner should be able to better understand the minimal risk of adverse systemic effects associated with inhaled corticosteroid therapy for patients with persistent asthma. Readers also should be able to recognize that the benefits of this preferred therapy clearly outweigh [...]
© 2008 HIV/AIDS News & Information