Study of Spirometry Patterns in Asthmatic Children on Long-Term Inhaled Steroids

Background: Asthma is a chronic inflammatory airway disease and one of the most common causes of childhood morbidity worldwide. Inhaled corticosteroids (ICS) are the mainstay of long-term management, effectively controlling inflammation and preventing exacerbations. However, concerns remain regarding their prolonged use and potential effects on lung function and growth in children. Spirometry is a key tool for objective assessment of pulmonary function and treatment response.

Objectives: To study spirometry patterns in asthmatic children on long-term ICS therapy and to evaluate changes in pulmonary function parameters over a one-year period.

Methods: This prospective observational study was conducted in the Department of Pediatrics, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Satara, Maharashtra, from September 2024 to August 2025. A total of 100 children aged 6-16 years with physician-diagnosed asthma on regular ICS therapy for ≥6 months were enrolled. Spirometry was performed at baseline and after 12 months following American Thoracic Society (ATS) standards. Parameters analyzed included Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), FEV₁/FVC ratio, and Peak Expiratory Flow Rate (PEFR). Data were compared with predicted values and analyzed using paired t-test.

Results: Among the 100 children (60 males, 40 females; mean age 10.8 ± 2.4 years), 68% had normal, 26% obstructive, and 6% mixed spirometry patterns at baseline. After one year, 79% had normal patterns, with significant improvement in mean FEV₁ (83.5 ± 12.6% to 90.1 ± 10.4%), FEV₁/FVC ratio (78.4 ± 6.2% to 82.3 ± 5.8%), and PEFR (80.7 ± 13.2% to 86.9 ± 11.7%) (p < 0.05). No restrictive pattern or functional decline was noted. The duration and dose of ICS did not significantly correlate with lung function deterioration. Minor local adverse effects occurred in 5% of children; no systemic effects were observed.

Conclusion: Long-term use of inhaled corticosteroids in asthmatic children leads to significant improvement and stabilization of pulmonary function without evidence of restrictive impairment or major adverse effects. Regular spirometric monitoring is essential for objective evaluation of treatment response and optimal asthma control.