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With four to six years of treatment, the nedocromil group had similar results as placebo, while children taking budesonide showed many improvements, such as fewer symptoms, fewer acute asthma attacks, fewer hospitalizations, and reduced airway hyperresponsiveness. The children in the budesonide group did experience a mild reduction in their growth rate during the first year of treatment that resulted in the group, on average, being about half an inch shorter than the children in the placebo and nedocromil groups. This effect persisted but did not increase over the duration of the clinical trial.
The growth of children and adolescents receiving orally inhaled corticosteroids, including QVAR, should be monitored routinely (., via stadiometry). If a child or adolescent on any corticosteroid appears to have growth suppression, the possibility that he/she is particularly sensitive to this effect should be considered. The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the risks associated with alternative therapies. To minimize the systemic effects of orally inhaled corticosteroids, including QVAR, each patient should be titrated to his/her lowest effective dose [see Dosage and Administration ( )] .