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Bone turnover during high dose inhaled corticosteroid treatment
N J Ali1, S Capewell, M J Ward
1Department of Chest Diseases, University of Wales College of Medicine, Llandough Hospital, Penarth.
Thorax
|March 1, 1991
Summary
High doses of beclomethasone dipropionate, an inhaled corticosteroid, significantly increased bone resorption markers and decreased bone mineralization markers in healthy men. Budesonide showed no significant effects on these bone turnover indices.
Area of Science:
- Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Inhaled corticosteroids (ICS) are widely used for respiratory conditions.
- High doses of ICS may affect bone turnover.
- Understanding the differential effects of ICS on bone health is crucial.
Purpose of the Study:
- To investigate the impact of high-dose beclomethasone dipropionate and budesonide on biochemical markers of bone turnover.
- To compare the effects of these two inhaled corticosteroids on bone metabolism.
Main Methods:
- A 28-day study involving healthy male subjects (n=16).
- Administration of high-dose beclomethasone dipropionate (2000 mcg/day) or budesonide (1800 mcg/day).
- Measurement of urinary hydroxyproline:creatinine, calcium:creatinine, plasma alkaline phosphatase, and parathyroid hormone levels.
Main Results:
- Beclomethasone dipropionate significantly increased urinary hydroxyproline:creatinine ratio (bone resorption marker) by 46% and decreased serum alkaline phosphatase (bone mineralization marker) by 7.4%.
- Budesonide did not produce significant changes in the measured biochemical indices of bone turnover.
- No significant changes in calcium:creatinine ratio or parathyroid hormone were observed for either drug.
Conclusions:
- High-dose inhaled beclomethasone dipropionate, unlike budesonide, adversely affects biochemical markers of bone turnover in healthy individuals.
- Further prospective studies in patients with respiratory diseases are warranted to evaluate the long-term effects of high-dose ICS on bone mass.