ICS is widely used as the first-line treatment of asthma. When standard doses of ICS do not control the disease, other anti-inflammatory drugs should be considered. This report aims to review the main adverse events induced by anti-inflammatory drugs in children with asthma and discuss possible actions to prevent or mitigate these effects.

Proper interpretation of ICS safety studies requires knowledge of the different ICS’s pharmaceutical properties and delivery device systems. Researchers found genetic variants affecting susceptibility to corticosteroid-induced adrenal suppression in children and adults who use ICS to treat their asthma. There is evidence of the association between montelukast use and neuropsychiatric events.

The benefits of ICS, properly prescribed and used, outweigh their potential adverse effects. There is evidence that the combination of ICS with long-acting beta2 agonists is safe for asthmatic children. Awareness of the potential risks of neuropsychiatric events in children taking montelukast should inform the clinicians’ prescribing practices. Omalizumab is well-tolerated, but the evidence on the safety of other biologic agents in children is scanty. Researchers must balance the risk of systemic adverse events with anti-inflammatory drugs against the dangers of uncontrolled asthma and frequent oral steroid use.

Reference: https://journals.lww.com/co-allergy/Abstract/2021/04000/Safety_of_anti_inflammatory_drugs_in_children_with.8.aspx