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Effect of high-dose fluticasone propionate on bone density and metabolism in children with asthma

Amanda L Griffiths1, Derrick Sim, Boyd Strauss

  • 1Department of Respiratory and Sleep Medicine, Monash Medical Centre, Clayton, and Centre for Heart and Chest Research, Monash University, Melbourne, Australia. agriffiths@paed.uwa.edu.au

Pediatric Pulmonology
|January 20, 2004
PubMed

Insights

High-dose inhaled fluticasone propionate (FP) did not significantly impact bone metabolism markers in children with asthma. Bone age-corrected bone mineral density also showed no significant reduction with prolonged FP use.

Area of Science:

  • Pediatric Pulmonology
  • Pediatric Endocrinology
  • Bone Metabolism

Background:

  • Long-term side effects of inhaled corticosteroids (ICS) are a significant concern.
  • High-dose inhaled fluticasone propionate (FP) is commonly used for persistent asthma in children.

Purpose of the Study:

  • To evaluate the effect of high-dose FP on biochemical markers of bone metabolism.
  • To assess bone mineral density (BMD) in children with asthma using high-dose FP.

Main Methods:

  • Cross-sectional study comparing children with asthma on high-dose FP (> 1,000 mcg/day) with healthy controls.
  • Analysis of serum bone formation markers and urine bone resorption markers.
  • Dual-energy X-ray absorptiometry (DEXA) for bone density assessment in a subgroup.

Main Results:

  • No significant differences in biochemical markers of bone metabolism between asthmatic children and controls.
  • A subgroup of asthmatic children showed lumbar spine density more than one standard deviation below the mean, which normalized after bone age correction.
  • Prolonged high-dose FP use did not lead to significant reductions in bone metabolism or bone age-corrected BMD.

Conclusions:

  • High-dose inhaled fluticasone propionate (FP) appears safe concerning bone metabolism and bone mineral density in children with asthma.
  • Bone age correction is crucial when interpreting BMD in pediatric populations.
  • Further longitudinal studies may be warranted to confirm these findings.

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