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Do inhaled corticosteroids lead to reduced bone density?

THE QUESTION Do inhaled corticosteroids lead to reduced bone density?

PAST STUDIES have shown that long-term use of oral corticosteroids, taken in pill form, may have adverse effects, including osteoporosis. Little such research has been done on the inhaled form of the drug.

THIS STUDY examined the effects of sustained corticosteroid use on the bone mineral density (BMD) of post-menopausal women who were being treated for asthma and other respiratory problems; some took the drug in inhalant form only, while others used both inhaled and oral formulations. Regardless of the type of drug taken, the women in both groups had used similar amounts of corticosteroids each day for eight years. The 106 women who used only inhaled corticosteroids had BMD levels similar to those of a matched group of healthy women who did not use any corticosteroids. The 49 women who used a combination of oral and inhaled corticosteroids, however, had substantially lower BMD than non-users.

corticosteroids

WHO MAY BE AFFECTED BY THESE FINDINGS? Women with asthma or other breathing disorders.

CAVEATS The results are not based on a randomized trial. In addition, the findings may not apply to men. Finally, different inhaled corticosteoids may not have the same effects on BMD.

BOTTOM LINE Women with breathing disorders may wish to consult their physician about using inhaled, rather than oral, corticosteroids.

FIND THIS STUDY January issue of the Journal of Allergy and Clinical Immunology

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