Effects of fluticasone propionate on bone mineral density in patients with persistent bronchial asthma

To evaluate osteoporosis in asthmatic patients.

Bone mineral density (BMD) was measured using three different methods, namely computed X-ray densitometry (CXD), digital image processing (DIP), and dual energy X-ray absorptiometry (DXA). The BMD data were standardized using the sex- and age-matched mean value of BMD.

One hundred and twenty-eight patients with persistent asthma.

The standardized BMD expressed as Z-score in asthmatic patients was significantly lower than the norm (Z-score -0.48 +/- 1.17, mean +/- SD). In patients who had been continuously treated with oral corticosteroids (OCS), the standardized BMD was significantly lower than that in patients treated without OCS. In addition, the standardized BMD in patients 60 years and over (Z-score -0.71 +/- 1.10, mean +/- SD, n = 58) had decreased to a greater extent than the decrease seen in patients under 60 years (Z-score -0.30 +/- 1.21, n=70). Moreover, BMD in these older patients decreased after a 6-month treatment protocol involving the use of an inhaled corticosteroid, fluticasone propionate (FP). During the 6 months, the treatment did not affect BMD in patients who were receiving FP for the first time. Although the BMD did not decrease in patients treated with FP without OCS, the BMD in patients treated with both FP and OCS decreased during the 6 months.

These results indicate that the continuous administration of OCS in patients with severe persistent asthma, particularly in older patients, may affect BMD in the short term even at a low OCS dose.