Bone density in asthmatic children treated with inhaled corticosteroids

Area of Science:

• Pediatric Endocrinology
• Respiratory Medicine
• Bone Metabolism

Background:

• Asthma is a common chronic respiratory disease in children.
• Inhaled corticosteroids (ICS) are a mainstay treatment for persistent asthma.
• Concerns exist regarding potential long-term effects of ICS on bone health in pediatric populations.

Purpose of the Study:

• To assess the volumetric trabecular bone mineral density (vTBMD) of the lumbar spine and distal radius (rTBMD) in prepubertal children with asthma.
• To determine if moderate to high doses of ICS impact bone density in this cohort.

Main Methods:

• A cohort of 20 prepubertal white children diagnosed with asthma was studied.
• Measurements of vTBMD and rTBMD were obtained using quantitative imaging techniques.
• Standard deviation scores (SDS) were calculated to compare bone density to age- and sex-matched references.

Main Results:

• The median SDS for lumbar spine vTBMD was 0.20 (range: -0.56 to 2.09).
• The median SDS for distal radius rTBMD was -0.04 (range: -0.82 to 1.39).
• Both vTBMD and rTBMD values were found to be within the normal range for healthy prepubertal children.

Conclusions:

• Moderate to high doses of inhaled corticosteroids do not appear to adversely affect volumetric trabecular bone mineral density in prepubertal children with asthma.
• These findings suggest that ICS can be safely used for asthma management in this age group without significant concern for detrimental effects on bone accrual.