Jan 30, 2015 By David Singer 3 min read

In the first clinical trial of its kind, an Allegheny Health Network study found a “small but statistically significant” disparity of growth rates between children who used nasal steroids for allergies and those who did not.

“This is the first study to be conducted in accordance to U.S. Food and Drug Administration guidelines,” said Dr. David Skoner, who oversaw the clinical trial.

The trial followed 216 children ages 3-9 over a year. Those who took a once-daily dosage of triamcinolone acetonide aqueous nasal spray (Nasacort AQ) showed average growth of 5.65 centimeters per year, while those on a placebo had an average of 6.09 centimeters of growth.

“Whether this is clinically significant is up for debate. But that this study captured such a minute measurement shows that it’s a good model for other steroid studies,” said Skoner, Director of Allergy, Asthma and Immunology medicine.

Nasacort and other nasal steroid brands have been available over the counter since October 2013. One of the parents who dealt with the side effects while it was still a prescription was Kristen Lee, of Arkansas, whose then-6-year-old daughter experienced adrenal gland suppression and stunted growth, and now has to be on human growth hormone.

“She has to have a shot every day now,” Lee said of her now-11-year-old daughter Maci, “and she will need to have a shot daily until after puberty.”

Maci dealt with complications of Cushing’s syndrome after being on the nasal steroid for nearly two years.

“An endocrinologist did blood work and other tests and this was it. She wasn’t on any other medications. Her body recovered from Cushing’s after a year, but her growth rate never bounced back,” Lee said.

But Lee is not making a horror story against steroids.

“They’re life-saving when used correctly. My son had cancer and they saved his life and the pain from side effects of bone marrow transplants. It’s just not a fix-all cure. They turned my daughter into an alien. She was bloated and unrecognizable,” Lee said.

Dr. Skoner said what happened to Lee happened in a clinical environment, meaning parents should be even more cautious when picking up over-the-counter steroids as part an allergy treatment regimen.

“Parents need to inform their doctor that this will be part of treatment,” he said,” because if a child is treating a skin condition with a steroid then adds to it something like Nasacort, the compounded effect of two steroids may adversely affect the child.”

“Our best friend is sometimes our worst enemy,” he continued, “but a doctor should – and a parent should be comfortable with – the doctor prescribing FDA-approved dosages of prescription drugs then also monitoring dosages of over-the-counter medications.”

What isn’t clear from the study is whether participants could recoup the lost height.

“A(n) (FDA-approved) study needs to be designed to find if its a permanent loss of height or if they could reach a height as if they never took the steroid by somehow catching up later,” Skoner said.

Skoner said steroids are still one of the most beneficial drugs to aid in battling various illnesses, but parents and doctors need clear communication when it comes to diagnosing and treating children with a steroid regimen.

The findings of the clinical trial were published in the Jan. 26 online edition of Pediatrics.