However, we would like to emphasize that all the authors of our article are very enthusiastic prescribers of inhaled steroids as a first-line treatment for patients with all but the mildest forms of asthma. Inflammatory processes are absolutely fundamental to the pathogenesis of asthma, and inhaled steroids are by far the most effective drugs at reducing inflammation in asthma patients. They are also the most effective drugs at reducing the burden of asthma (ie, improving exercise tolerance, reducing days lost from school, preventing acute exacerbations, preventing hospital admissions, and decreasing the risk of death from asthma). In the vast majority of patients, the benefits greatly outweigh the risks. For example, in a long-term study (mean study duration, 9.92 years) of budesonide treatment (patient age range, 3 to 13 years) with a mean daily dose of 412 μg/d (dose range, 110 to 887 μg/d), there was no effect on final adult height and no evidence of any other significant side effects.2 This is most compelling and reassuring evidence of the long-term safety at least of this particular inhaled steroid in children.