Main Research Findings

A study comparing the efficacy and safety of inhaled budesonide and mometasone in Chinese children with mild persistent asthma, 1 , suggested that budesonide inhalation therapy was comparable to mometasone in terms of efficacy and safety. On the other hand, another study, 2 , reported a case of aseptic femoral head necrosis associated with the long-term use of inhaled fluticasone propionate and intranasal triamcinolone acetonide. Long-term use of inhaled corticosteroids can lead to systemic side effects such as adrenal insufficiency, growth suppression, glaucoma, and osteoporosis.

Reasons for Side Effects

Inhaled corticosteroids, while effective in reducing airway inflammation, can cause various side effects when used long-term due to the drug being absorbed from the airways and acting systemically. Children are particularly susceptible to growth suppression from inhaled corticosteroids due to their rapid growth.

Common Side Effects

Growth Suppression

1 , 2 indicate that long-term inhaled corticosteroid use can cause growth suppression.

Adrenal Insufficiency

2 suggests that long-term inhaled corticosteroid use can lead to adrenal insufficiency.

Glaucoma

2 indicates that long-term inhaled corticosteroid use can cause glaucoma.

Osteoporosis

2 suggests that long-term inhaled corticosteroid use can lead to osteoporosis.

Avascular Osteonecrosis of the Femoral Head

2 reports a case of avascular osteonecrosis of the femoral head associated with long-term inhaled fluticasone propionate and intranasal triamcinolone acetonide.

Side Effects Management

Growth Suppression Management

To minimize the risk of growth suppression, doctors should monitor children's growth regularly and adjust the inhaled corticosteroid dose as needed.

Adrenal Insufficiency Management

To minimize the risk of adrenal insufficiency, doctors should regularly monitor patients' adrenal function.

Glaucoma Management

To minimize the risk of glaucoma, doctors should monitor patients' eye pressure regularly.

Osteoporosis Management

To minimize the risk of osteoporosis, doctors should monitor patients' bone density regularly and recommend calcium and vitamin D intake as needed.

Study Comparison

Commonalities between Studies

Both studies suggest that inhaled corticosteroid use can cause various side effects in children.

Differences between Studies

1 compares the efficacy and safety of budesonide and mometasone, while 2 is a case report on the association of fluticasone and triamcinolone acetonide use with avascular osteonecrosis of the femoral head. The two studies investigate different inhaled corticosteroids and different side effects, making direct comparison difficult.

Practical Application Considerations

While inhaled corticosteroids are effective for asthma treatment, long-term use can cause various side effects in children, including growth suppression. Therefore, it is crucial to take the appropriate dosage as instructed by a doctor. Regular monitoring of children's growth and adjustment of inhaled corticosteroid doses as necessary are essential.

Current Research Limitations

These studies investigated side effects of inhaled corticosteroids but did not evaluate their effectiveness in improving asthma symptoms. Additionally, these studies examined the association of specific types of inhaled corticosteroids with particular side effects, but not all inhaled corticosteroids cause the same side effects. Furthermore, these studies targeted specific age groups of children and may not be universally applicable to all children. Therefore, consider these study findings as references, and it is essential to use inhaled corticosteroids under a doctor's guidance.

Future Research Directions

Further research on inhaled corticosteroid side effects is crucial. It is particularly important to investigate the incidence and severity of side effects with different types of inhaled corticosteroids, in children of different age groups, and at various dosage levels. Additionally, developing new treatments and preventive measures for mitigating inhaled corticosteroid side effects is necessary.

Conclusion

Inhaled corticosteroids are effective for asthma treatment, but long-term use can cause various side effects in children, including growth suppression. Therefore, it is essential to take the appropriate dosage as instructed by a doctor. Regular monitoring of children's growth and adjustment of inhaled corticosteroid doses as necessary are essential. Further research on the side effects of inhaled corticosteroids is needed.