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Ann Allergy Asthma Immunol. 2005 Jan;94(1):15-21; quiz 22-3, 79.

Effects of inhaled corticosteroids on bone.

Author information

1
Division of Respiratory Medicine, Nottingham University City Hospital, Nottingham, England. Kevin.Mortimer@nottingham.ac.uk

Abstract

OBJECTIVE:

To discuss the effects of inhaled corticosteroids on bone and their potential public health implications.

DATA SOURCES:

The MEDLINE and EMBASE databases were searched to identify articles published between 1966 and January 2004 with the following keywords in the title: inhaled corticosteroid, beclomethasone, budesonide, flunisolide, fluticasone, mometasone, triamcinolone plus bone, fracture, osteoporosis, osteocalcin, growth, or height.

STUDY SELECTION:

Key studies of adequate size and duration that allowed for potential confounding factors where required were selected.

RESULTS:

Inhaled corticosteroids are absorbed into the systemic circulation and therefore have the potential to cause adverse effects on bone. Several of the larger studies showed that inhaled corticosteroids cause a dose-related reduction in bone mineral density. Three cross-sectional studies found a dose-related increase in fractures in people taking an inhaled corticosteroid compared with controls. Prospective studies found a short-term reduction in growth velocity in children taking an inhaled corticosteroid, although target adult height is usually achieved.

CONCLUSION:

Since osteoporotic fracture is common in elderly patients and up to 5% of the population in more developed countries take an inhaled corticosteroid, these findings have public health implications. Strategies are needed to reduce the systemic effects of inhaled corticosteroids.

PMID:
15702810
DOI:
10.1016/S1081-1206(10)61280-X
[Indexed for MEDLINE]
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