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| |  Asthma Specialists Urge Patients To Continue With Their Medications MILWAUKEE, WI -- Nov. 17, 1998 -- A joint public statement from five American medical organisations has reiterated the United States Food and Drug Administration’s request that asthmatic children not be taken off prescribed corticosteroids without first speaking to their child's doctor. The FDA has decided that pharmaceutical companies that supply orally inhaled or intranasal corticosteroids must include new information on the potential effects of their use in children. The new labelling language will alert health providers that using these drugs in children may reduce their rate of growth. The agency also is recommending using the lowest effective dose of these drugs and routine monitoring patients' growth rates. The public statement has been issued by the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the American Academy of Pediatrics (AAP). "Patients are advised not to stop using their inhaled or intranasal corticosteroids without first speaking to their health care providers about the benefits of these drugs compared to their risks,” the FDA stated. The five national organisations of physicians, including medical specialists who treat asthma, also urged parents to continue with prescribed treatments and to discuss any concerns with their child's physician. The new product labelling does not suggest that the products are unsafe or that their use should be limited. In fact, the real risk to health would be in stopping prescribed therapy without consulting the child's physician. Inhaled corticosteroids are frequently the drug of choice in the treatment of asthma. Recent controlled clinical studies suggest that inhaled corticosteroids may cause a small reduction in the rate of growth in pediatric patients. The average reduction in growth rate observed in the studies was about one centimetre (a third of an inch) per year. The reduction may be related to dose and how long the child takes the drug. Consequently, it is recommended that physicians use the lowest effective dose of these drugs and that they routinely monitor their patients' growth rates. The long-term effect of any reduction in growth rate on final adult height is unknown. Likewise, it has not yet been determined whether patients' growth will catch up if treatment is discontinued. Physicians and pharmaceutical manufacturers will continue to monitor these drugs to learn more about long-term effects. The appropriate prescription and use of asthma medications is an essential component of successful asthma management. The selection of medications depends on the frequency and severity of asthma and on factors that trigger or aggravate asthma symptoms. Inhaled corticosteroids, which are one of the most effective medications for controlling asthma, are anti inflammatory medications that reduce swelling in the airways, improve lung function and act to prevent asthma episodes or asthma attacks. Early intervention with inhaled corticosteroids can improve asthma control and may prevent irreversible airway injury. The appropriate use of inhaled corticosteroids is recommended in the current Guidelines for the Diagnosis and Management of Asthma, the Expert Panel #2 report of the National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung and Blood Institute. Inhaled corticosteroids are known to have far fewer side effects than the long-term use of oral formulations of these drugs. Patients should never change or discontinue prescribed asthma medications unless advised by their doctor. To understand the balance of risks versus benefits, parents are encouraged to discuss any concerns with their child's physician.
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