Does Duasma Affect Growth in Children with Asthma?

Q: Does Duasma Affect Growth in Children with Asthma?

Dear dahsuangspec： <br>The active ingredient in Duasma (Budesonide) is a corticosteroid, and there has been ongoing controversy regarding the impact of corticosteroids on children's growth and development, particularly in terms of height. <br>Therefore, it is crucial to closely m

Development?

Hello, my seven-year-old child is currently using Duasma (DuoNeb) to treat asthma.
Will this affect their development? Thank you.

dahsuangspec, 50~59 year old female. Ask Date: 2008/01/25

Dr. Liao Lingmei reply Pharmacology

Dear dahsuangspec:
The active ingredient in Duasma (Budesonide) is a corticosteroid, and there has been ongoing controversy regarding the impact of corticosteroids on children's growth and development, particularly in terms of height.
Therefore, it is crucial to closely monitor the use of such medications in infants and children, or to use the lowest effective dose whenever possible.
Numerous clinical trials, both large and small, have published related reports as researchers seek to find answers.
However, a definitive conclusion regarding whether these medications affect children's height remains elusive, as various factors can influence the trial outcomes, such as the number of children participating, age distribution, dosage of the medication, duration of use, and the design of the clinical trial itself.
Additionally, it is possible that any observed reduction in height could be attributed to asthma itself.
Only through large-scale, retrospective, long-term follow-up studies (tracking children's growth into adulthood) can we hope to confirm the answer.
When physicians incorporate such medications into treatment plans, they typically assess the risks and benefits.
It is advisable to discuss the dosage and duration of use with your physician to achieve the goal of effective treatment while ensuring healthy growth.
Wishing you health and happiness.

Reply Date: 2008/01/25

More Info

Duasma, which contains budesonide, is a corticosteroid used in the management of asthma, particularly in children. The question of whether corticosteroids like budesonide affect growth in children is a significant concern among parents and healthcare providers. The relationship between corticosteroid use and growth in children has been a topic of extensive research, and while there is evidence suggesting potential impacts, the results are often nuanced and depend on various factors.

Corticosteroids are known to have anti-inflammatory properties, which are crucial in managing asthma symptoms and preventing exacerbations. However, long-term use of systemic corticosteroids has been associated with growth suppression in children. This is primarily due to their effects on the hypothalamic-pituitary-adrenal (HPA) axis, which can lead to a decrease in growth hormone secretion and potentially affect bone growth and development.

In the case of inhaled corticosteroids (ICS) like budesonide, the risk of growth suppression appears to be lower compared to systemic corticosteroids. Studies have shown that while there may be a slight reduction in growth velocity in children using inhaled corticosteroids, the overall impact on final adult height is less clear. Some studies suggest that the growth suppression is minimal and may be reversible upon discontinuation or reduction of the medication.
The variability in the effects of budesonide on growth can be attributed to several factors, including the dose and duration of treatment, the individual child's response, and the presence of underlying asthma severity. For instance, children with poorly controlled asthma may experience more significant growth issues due to the effects of the disease itself, rather than the medication. Therefore, it is essential to balance the benefits of asthma control with the potential risks of growth suppression.

Current guidelines recommend using the lowest effective dose of inhaled corticosteroids to manage asthma symptoms while minimizing potential side effects. Regular monitoring of growth in children receiving long-term corticosteroid therapy is advisable. If concerns about growth arise, healthcare providers may consider adjusting the medication regimen, including switching to a different class of medications or using a combination therapy that includes non-steroidal options.

In conclusion, while there is a potential for inhaled corticosteroids like Duasma (budesonide) to affect growth in children, the impact is generally considered to be minimal, especially when used at appropriate doses. It is crucial for parents to maintain open communication with their child's healthcare provider to ensure that asthma is well-managed while also monitoring growth and development. Regular follow-ups and assessments can help address any concerns and make necessary adjustments to the treatment plan.

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