Inhaled Corticosteroids and Endocrine Effects in Childhood

Endocrinol Metab Clin North Am. 2020 Dec;49(4):651-665. doi: 10.1016/j.ecl.2020.07.003. Epub 2020 Oct 13.

Abstract

Asthma is the most common chronic inflammatory disease of children, and inhaled corticosteroids (ICSs) are the most effective and commonly used treatment of persistent asthma. ICSs currently approved for and commonly used by children with asthma include beclomethasone dipropionate, budesonide, fluticasone propionate, mometasone furoate, ciclesonide, and triamcinolone acetonide. This article reviews 4 areas critical to understanding potential adverse endocrine outcomes of ICSs and placing them in proper perspective: (1) influence of drug/delivery device properties on systemic steroid burden; (2) adrenal insufficiency during ICS treatment; (3) growth effects of ICS and asthma itself; and (4) bone mineral accretion during ICS therapy.

Keywords: Adrenal suppression; Growth; Inhaled corticosteroids.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects*
  • Bone Diseases, Metabolic / chemically induced*
  • Child
  • Dry Powder Inhalers
  • Endocrine System Diseases / chemically induced*
  • Growth Disorders / chemically induced*
  • Humans
  • Metered Dose Inhalers

Substances

  • Adrenal Cortex Hormones