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PEDIATRICS Vol. 110 No. 2 August 2002, pp. 461


ASTHMA: STEROID THERAPY

Bone Density in Asthmatic Children Treated with Inhaled Corticosteroids

John M. Kelso, MD

San Diego, CA, USA

Purpose of the Study. Inhaled corticosteroids (ICS) have been shown to have some systemic absorption and thus have some potential for adverse effects on bone density.

Study Population. A total of 20 prepubertal children (11 girls, 9 boys; aged 4–9 years, median age: 7.6 years) with chronic asthma taking moderate- to high-dose ICS for at least 12 months. The average doses used in µg/m2/day were beclomethasone 778 (n = 5), budesonide 819 (n = 9) and fluticasone 444 (n = 6).

Methods. Bone mineral density of vertebrae and distal radius measured by quantitative computed tomography. Bone mineral density values as well as heights were transformed into standard deviation scores and compared with normal values from healthy children.

Results. The values for bone mineral density, as well as for height, were not different than the expected values for normal children.

Conclusion. "ICS do not adversely affect bone mineral density in prepubertal asthmatic children."

Reviewer’s Comments. We should still use as low a dose of ICS as possible, but this is yet another reassuring study that these very effective drugs are also very safe.

REFERENCES

Reilly SM, Hambleton G, Adams JE, Mughal MZ. Arch Dis Child.2001; 84 :183 –184[Abstract/Free Full Text]


PEDIATRICS (ISSN 1098-4275). ©2002 by the American Academy of Pediatrics

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