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Inhaled corticosteroids and bone density of children with asthma
Nerin N Bahceciler1, Gülay Sezgin, Mustafa A Nursoy
1Marmara University Hospital, Department of Pediatrics, Division of Pediatric Allergy/Immunology, Istanbul, Turkey. aonder@attglobal.net
Insights
Inhaled corticosteroids (ICS) like budesonide do not significantly impact bone mineral density (BMD) in children with asthma. This study found no differences in total body or spine BMD between children treated with ICS and those who were not.
Area of Science:
- Pediatric Pulmonology
- Pediatric Endocrinology
- Radiology
Background:
- Inhaled corticosteroids (ICS) are a cornerstone treatment for childhood asthma.
- Concerns exist regarding potential long-term effects of ICS on bone mineral density (BMD) in pediatric populations.
- Budesonide is a commonly prescribed ICS for managing asthma in children.
Purpose of the Study:
- To compare anteroposterior (AP) spine and total body bone mineral density (BMD) in children with asthma treated with long-term inhaled budesonide versus those never treated with ICS.
- To assess the safety of inhaled budesonide therapy concerning bone health in pediatric asthma patients.
Main Methods:
- A cross-sectional study comparing two groups of asthmatic children: Group I (n=52) treated with inhaled budesonide and Group II (n=22) treatment-naïve to ICS.
- Measurements included anteroposterior (AP) spine and total body bone mineral density (BMD).
- Groups were matched for age, gender, weight, height, Tanner's stage, and disease duration.
Main Results:
- No statistically significant differences were observed in total body BMD (p = 0.214) between the budesonide-treated group and the control group.
- Similarly, no significant differences were found in anteroposterior (AP) spine BMD (p = 0.661) between the two groups.
- Children in Group I received a mean cumulative dose of 154.0±135.3mg of budesonide over a mean duration of 13.0±9.8 months.
Conclusions:
- Long-term treatment with inhaled budesonide in children with asthma does not appear to adversely affect bone mineral density.
- These findings support the safety of inhaled corticosteroid (ICS) therapy for bone health in pediatric asthma management.
- Further research may explore other potential long-term effects, but current evidence suggests bone density is not a significant concern.
Abstract:
In this cross-sectional study, we aimed to compare anteroposterior (AP) spine and total body bone mineral density (BMD) measurements of children with asthma treated with long-term inhaled budesonide (n = 52, mean age 6.4+/-2.2yr, M/F = 22/30) (Group I) with those of asthmatic children who had never received treatment with inhaled corticosteroids (Group II) (n = 22, mean age 6.8+/-2.2, M/F = 10/12). Boys and girls were comparable for age, weight, height, cumulative corticosteroid (CS) dosage, duration of disease and inhaled corticosteroid (ICS) treatment within each group. The mean total accumulated dosage of budesonide for children in Group I was 154.0+/-135.3mg (mean daily dosage = 419+/-154 microg) and the mean treatment duration was 13.0+/-9.8 months. The two groups were comparable with respect to age, gender, weight, height, Tanner's stage and duration of disease. There was no significant difference between subjects in the two groups for total (p = 0.214) and (AP) spine BMD results (p = 0.661), respectively. Our results provide additional support for the safety of ICS therapy on bone density of asthmatic children.