Biochemical markers of bone metabolism and calciuria with inhaled budesonide therapy

Akil, İpek; Yüksel, Hasan; Ürk, Vildan; Var, Ahmet; Onur, Ece

doi:10.1007/s00467-004-1418-z

Cited by 8 publications

(3 citation statements)

References 22 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As an example, Boot et al (30) did not find differences in mean osteocalcin, PICP, and ICTP levels between asthmatic children treated with ICS and controls. In contrast, Akil et al (28) found a significant decrease in osteocalcin and increase in ICTP levels compared with pretreatment values in a study in 22 asthmatic children. Also, in the study comparing high-dose with low-dose fluticasone propionate, significant initial reductions in osteocalcin and PINP levels were noticed without a difference in effect on BMD (12).…”

Section: Discussionmentioning

confidence: 79%

Bone Mineral Density in Children Treated With Daily or Periodical Inhaled Budesonide: The Helsinki Early Intervention Childhood Asthma Study

et al. 2010

View full text Add to dashboard Cite

ABSTRACT:In a double-blind, randomized study, 136 children, 5-10-y-old, with newly detected persistent asthma received budesonide (BUD) 400 g twice daily for 1 mo and thereafter 200 g twice daily for 5 mo. Thereafter, 50 children were treated with BUD 100 g twice daily, whereas 44 children used BUD as needed for 1 y; an additional 42 children received disodium cromoglycate (DSCG). Asthma exacerbations were treated with BUD for 2 wk in a dose of 400 g twice daily in all groups. In this secondary analysis, bone mineral density (BMD) of the lumbar vertebrae was measured before and after the 18-mo treatment. Compared with DSCG, regular BUD treatment resulted in a significantly smaller increase in BMD (0.023 versus 0.034 g/cm 2 ; p ϭ 0.023) and height (7.75 versus 8.80 cm; p ϭ 0.001). Periodic treatment did not affect BMD. No intergroup differences were observed when BMD data were adjusted for changes in height. Daily BUD treatment in prepubertal children may slow down the increment in BMD and standing height. This was not observed in children receiving BUD periodically after the initial regular BUD treatment. The correlation between height and BMD suggests that following children's height might afford an estimation of inhaled corticosteroid effects on bone. (Pediatr Res 68: 169-173, 2010) I nhaled corticosteroids (ICS) are recommended first-line treatment for all patients with persistent asthma (1). Systemic exposure to corticosteroids can suppress bone formation and increase bone resorption resulting in loss of bone mass and risk of fractures (2). Also, in children, the use of oral steroids has been associated with a dose-dependent increase in fracture risk (3). Case-control studies, too, have identified an increased risk of fractures with high doses of ICS (4,5), particularly in elderly patients (6). Therefore, there has been some concern that the use of ICS as long-term asthma maintenance therapy in children could have a detrimental effect on bone mineral density (BMD) and risk of fractures.A recent Cochrane systematic review found that low to moderate doses of ICS did not affect BMD or risk of fractures in adults (7). However, it is not possible to extrapolate findings from adults to children. Bone mass in children is also influenced by height, age, race, exercise, presence of chronic illnesses, and especially the stage of puberty (8).The clinically most important outcome for the effects of ICS on bone is an increased risk of fractures. This is not easy to study, particularly, in children in randomized prospective trials. The use of biochemical markers is restricted to describe bone metabolism, but BMD has been used as a surrogate marker of an increased susceptibility to fractures. In this respect, BMD has some power to predict fractures (9). Therefore, prospective, randomized, long-term (Ͼ12 mo) controlled trials using clinically relevant doses of ICS with adjustment for confounders and with BMD as an endpoint seem to be the best way to assess the risk of clinically important adverse effects of ICS on the bone ...

show abstract

Section: Discussionmentioning

confidence: 79%

Bone Mineral Density in Children Treated With Daily or Periodical Inhaled Budesonide: The Helsinki Early Intervention Childhood Asthma Study

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Akil et al reported that biochemical markers of bone metabolism were not significantly different between controls and asthmatic children [ 28 ].…”

Section: Discussionmentioning

confidence: 97%

Evaluating Bone Metabolism In Asthmatic Cases Using Inhaled Steroids

2006

IJPN

View full text Add to dashboard Cite

Background: Bronchial asthma is a chronic inflammatory disease in which eosinophils and different cells play a major role in pathogenesis, characterized by increased bronchial sensitivity of the airways. Topical steroids had been used to avoid long-term side effects of systemic steroids in asthma. The systemic effects of inhaled corticosteroids may be explained by the combined effects of many factors. Objective: This study was performed to investigate the effects of inhaled steroids on bone mineralization and also on bone density. Methods: Ninety-seven children divided into three groups, diagnosed with bronchial asthma and followed up in 2002 and 2003 at the GATA Haydarpasa Teaching Hospital were included in the study. Bone remodeling and destruction markers were used to examine the effects of inhaled steroids on bone metabolism. Results: Comparisons between groups and among all three groups revealed no statistical differences in bone specific alkaline phosphatase (bALP), hydroxyproline (HP), carboxy-terminal telopeptide of type1 collagen (ICTP), calcium-creatinine ratio (Ca/GF), calcium (Ca) and phosphor (P) levels. Analysis of the groups in the study revealed that bone mineral density (BMD) scores were significantly higher in pubertal stage cases compared with those in the prepubertal stage. Conclusion: No negative effect of inhaled steroid treatment on BMD was observed, and care must be taken over the use of the lowest dosage possible, especially in children, to keep respiratory functions and symptoms under control.

show abstract

“…There are good examples where the concentrations of the endogenous protein or its soluble forms are increased because of a compensatory mechanism. [7][8][9][10] Investigation will be warranted in such scenarios. An understanding of the biology behind the therapeutic, including the compensatory mechanisms, can help defi ne the investigation that should be used in examining the specifi city of a particular method.…”

Section: Challenges Of Lba For Specificity and Selectivity Evaluationsmentioning

confidence: 99%

Specificity and selectivity evaluations of ligand binding assay of protein therapeutics against concomitant drugs and related endogenous proteins

Lee

2007

AAPS J

View full text Add to dashboard Cite

Biochemical markers of bone metabolism and calciuria with inhaled budesonide therapy

Cited by 8 publications

References 22 publications

Bone Mineral Density in Children Treated With Daily or Periodical Inhaled Budesonide: The Helsinki Early Intervention Childhood Asthma Study

Bone Mineral Density in Children Treated With Daily or Periodical Inhaled Budesonide: The Helsinki Early Intervention Childhood Asthma Study

Evaluating Bone Metabolism In Asthmatic Cases Using Inhaled Steroids

Specificity and selectivity evaluations of ligand binding assay of protein therapeutics against concomitant drugs and related endogenous proteins

Contact Info

Product

Resources

About