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Bone studies in patients on prolonged systemic corticosteroid therapy for asthma
Clinical Allergy
|July 1, 1982
Summary
Corticosteroid treatment for severe asthma may reduce bone density, particularly in the metacarpal bone. However, the risk of vertebral fractures remains low, supporting cautious corticosteroid use.
Area of Science:
- Endocrinology
- Rheumatology
- Pulmonology
Background:
- Corticosteroid therapy is essential for managing severe chronic asthma.
- Long-term corticosteroid use is associated with decreased bone mineral density and increased fracture risk.
Purpose of the Study:
- To evaluate the effects of long-term corticosteroid treatment on bone structure in patients with chronic asthma.
- To assess the incidence of vertebral fractures in this patient cohort.
Main Methods:
- Radiographic assessment of second metacarpal bone cortical thickness.
- Evaluation of lumbar spine fractures in 21 Caucasian patients with corticosteroid-dependent asthma.
- Analysis of treatment duration (prednisone years) and cumulative prednisone dose.
Main Results:
- 61.9% of patients showed reduced cortical thickness (1-2 SD below normal).
- Only 19% had cortical thickness below 2 SD.
- Vertebral fractures were present in only one patient (4.8%).
Conclusions:
- Long-term corticosteroid therapy in severe asthma is linked to reduced bone cortical thickness.
- The incidence of vertebral fractures in this group is not significantly elevated.
- Cautious use of appropriate corticosteroid regimens at the lowest effective dose is recommended for chronic asthma management.