Is long-term inhaled hormone therapy safe for a child with asthma?

Has the child been diagnosed with bronchial asthma , and has the doctor prescribed hormone inhalation? Panic seizes many mothers: “So small! What will happen to him now? Will he get fat? Will his growth and sexual development slow down? Is it really worth being afraid of inhaled hormonal drugs? Let’s try to dispel common myths.

Hormones are not as scary as people think they are.

Distrust of hormone therapy is a common phenomenon. There is even a term – ” steroidophobia “, or fear of hormones. But fear is half the trouble. Worse – its consequences, when patients refuse adequate treatment, interrupting the course or partially fulfilling the doctor’s prescriptions, and thereby expose themselves or children to mortal danger.

This fear comes from the 1950s, when hormonal drugs really had a lot of side effects: weight gain, swelling, growth retardation, etc. But for almost 70 years, pharmacology has stepped far forward, so modern hormonal drugs act much more carefully and, most importantly, more efficient. Moreover, hormonal therapy in some cases becomes the life-saving remedy that can significantly improve the quality of human life. For example, with diseases of the reproductive system, thyroid gland, diabetes.

Thus, the use of glucocorticosteroids in the form of inhalation is a real revolution in the treatment of bronchial asthma. The drug is delivered directly to the bronchi without affecting other body systems. The therapeutic effect is achieved quickly, with a minimum of side effects 1,2 .

Popular myths about IGCS

Myth 1. The child will begin to increase weight, which will be impossible to control.

Reality. Inhaled glucocorticosteroids enter the systemic circulation in small quantities, which reduces the risk of systemic side effects that can develop when using glucocorticosteroids in tablet form and injections 1 .

Myth 2. “Hormonal drugs are addictive, and it is difficult to give them up even after the end of therapy, as the body stops producing its own hormones. Therefore, you will have to “sit on steroids” all your life.

Reality. Hormones are always canceled gradually. 2 As the dose of the active substance decreases, the body increases the production of its own hormones. Therefore, with the correct cancellation of the hormonal drug, the body is not in danger. 2

Myth 3. Hormones do not work.

Reality. According to international and Russian recommendations for the treatment of bronchial asthma, currently inhaled glucocorticosteroids are the most effective drugs for controlling asthma of any severity. 3-5

Myth 4. It is better to start asthma treatment with non-hormonal drugs, as they are safer for the child.

Reality. In international and Russian protocols for the treatment of bronchial asthma in children, it is recommended to start with inhaled glucocorticosteroids , because they allow you to control the course of the disease more effectively than other drugs. 3-5 According to various studies, patients who started therapy with inhaled glucocorticosteroids late (after 5 years from the onset of asthma symptoms) had significantly reduced lung function compared with those patients who started treatment promptly 8 Moreover, the main cause of death in exacerbation of asthma is the absence, insufficient or late use of inhaled glucocorticosteroids. 6.7

Myth 5. “Now it will help me, and then I will have to constantly increase the dose!”

Reality Once control of asthma is achieved, doses of glucocorticosteroids are reduced. 2

What do the doctor’s say?

PROJECT EXPERT

Denisova Anita Robertovna

Candidate of Medical Sciences, pediatrician, allergist-immunologist

“Efficacy and safety of inhalation glucocorticosteroids used for nebulizer therapy, proven by research. To date, it has been studied in a large number of studies involving tens of thousands of patients, and these are statistical data.”

PROJECT EXPERT

Ivanova Natalya Alexandrovna

Candidate of Medical Sciences, Associate Professor of the Department of Children’s Diseases of the Military Medical Academy

“Inhaled glucocorticosteroids act directly on the bronchial mucosa in such a way that inflammation subsides and the threat of developing irreversible changes in the bronchial wall disappears, the risk of exacerbations decreases, and the quality of life of children and their parents improves.”

Single patient history*

Maria K.

Young mom

– Andryusha fell ill when he was a year old, – says a young mother Maria K. – At first I just coughed, there was no temperature, and I didn’t think that it could be something serious. But as time went on, his condition worsened. Different doctors made different diagnoses. After several courses of antibiotics, we rushed to the hospital, where we were discharged with a “residual cough.” But soon it all started again. We turned to another doctor, Ph.D., with whom we were very lucky. He diagnosed Andryusha with bronchial asthma and prescribed inhaled corticosteroids for nebulizer therapy. When I found out that it was a hormone, I was scared. But the doctor explained that inhaled glucocorticosteroids go directly to the lungs, practically bypassing the bloodstream. This explains their high efficiency and minimum side reactions. After several inhalations, Andryusha felt better, and the cough soon stopped. Seven years have passed since then, and as prescribed by the doctor, from time to time we undergo therapy for several months. But now I do not doubt the correctness of the treatment.

event_note August 3, 2022

account_box Kroll

Leave a Reply

Your email address will not be published. Required fields are marked *