A METAANALYSIS OF THE EFFECT OF ORAL AND INHALED CORTICOSTEROIDS ON GROWTH

This analysis summarizes studies comparing attained heights with expec ted heights of children with asthma treated with inhaled or oral corti costeroids. The possible moderating effects of treatment duration, and dosage and asthma severity are also examined. A preliminary database of 95 articles rendered 21 includable studies representing 810 patient s with asthma, which yielded 29 tests of the corticosteroid-growth eff ect. Statistical integration of the results of these studies revealed a significant but small tendency for corticosteroid-growth effect. Sta tistical integration of the results of these studies revealed a signif icant but small tendency for corticosteroid therapy in general to be a ssociated with diminished final height (Z = 2.328, p = 0.01, mean r = -0.023). However, this effect varied for the specific drugs under cons ideration. As expected significant weak growth impairment was observed for prednisone (Z = 2.137, p = 0.0164, mean r = -0.295) and ''other o ral corticosteriods'' (Z = 9.107, p = 2.44E-18, mean r = -0.260). On t he other hand, a significant moderate tendency was observed for inhale d beclomethasone dipropionate therapy to be associated with attaining normal stature (Z = 7.395, p = 2.17E-13, mean r = +0.43). There was no statistical evidence for beclomethasone diproprionate therapy to be a ssociated with growth impairment at higher doese, for longer therapy d urations, or among patients with more severe asthma. This meta-analyti c integration indicated that available studies of inhaled beclomethaso ne dipropionate therapy do not show an association between its use and the adverse effect of diminshed stature.