Statural growth (14 studies, n=unclear):
Five RCTs compared low-dose inhaled corticosteroids (100-200 micrograms per day) with placebo or non-steroidal therapy. None of these found that inhaled corticosteroids exert any overall adverse effect on statural growth. Seven RCTs compared higher-dose inhaled corticosteroids (336-1,000 micrograms per day) with placebo or non-steroidal therapy. With the exception of one study that found 600 micrograms per day budesonide had no impact on growth over 22 months compared to placebo, all found some degree of apparent growth retardation in children treated with high-dose inhaled corticosteroids. Two RCTs compared fluticasone propionate (200 micrograms) against beclometasone (200 micrograms per day via dry-powder inhaler or 400 micrograms per day via pressurised metered dose inhaler), both of which reported a significantly higher growth rate in children receiving fluticasone propionate.
BMD (4 studies, n=unclear):
All four RCTs reported that inhaled corticosteroid therapy had no effect on BMD.
Cortisol levels (10 studies, n=unclear):
In general, studies of recommended doses of inhaled corticosteroids found little or no effect on measures of hypothalamic-pituitary-adrenal (HPA) axis function over 12 to 36 months follow-up. Two RCTs compared fluticasone propionate (200 micrograms) against different doses of beclometasone. One study found no difference between fluticasone propionate and beclometasone 200 micrograms per day. The second study found a significant reduction in mean serum cortisol levels versus baseline in children receiving 400 micrograms per day beclometasone from week 10 to month 20, with no reduction in the fluticasone propionate group.