Effects of inhaled corticosteroids on bone

Bootsma, Gerben; Dekhuijzen, P.N.R.; Festen, J.; Herwaarden, C.L.A. van

doi:10.1016/s0300-2977(97)00028-4

Cited by 6 publications

(3 citation statements)

References 57 publications

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“…In the general practice setting, 40 prescriptions for inhaled GCs are written for every one prescription for oral GCs. Inhaled GCs have been associated with decreases in bone density, and doses of inhaled GCs (budesonide, beclomethasone dipropionate or fluticasone propionate) above 1000 μg day −1 may cause a dose‐dependent decrease in osteocalcin levels [33]. Although in most published studies it has proved impossible to quantify the contributions of previous treatment with oral GCs and other confounding factors related to bone loss [33, 34], the statistical power of these studies is too low to rule out a clinically significant effect.…”

Section: The Scope Of the Problemmentioning

confidence: 99%

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A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update

Eastell

Reid

Compston

et al. 1998

Journal of Internal Medicine

290

159

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. Eastell R, Reid DM, Compston J, Cooper C, Fogelman I, Francis RM, Hosking DJ, Purdie DW, Ralston SH, Reeve J, Russell RGG, Stevenson JC, Torgerson DJ (University of Sheffield Medical School, Sheffield; University of Aberdeen, Aberdeen; University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge; Southampton General Hospital, Southampton; Guy's Hospital, London; Freeman Hospital, Newcastle upon Tyne; Nottingham City Hospital, Nottingham; Hull Royal Infirmary, Hull; Wynn Institute for Metabolic Research, London; and the University of York, York, UK). A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update (Review). J Intern Med 1998; 244: 271–292. In the UK, over 250 000 patients take continuous oral glucocorticoids (GCs), yet no more than 14% receive any therapy to prevent bone loss, a major complication of GC treatment. Bone loss is rapid, particularly in the first year, and fracture risk may double. This review, based wherever possible on clinical evidence, aims to provide easy‐to‐use guidance with wide applicability. A treatment algorithm is presented for adults receiving GC doses of 7.5 mg day−1 or more for 6 months or more. General measures, e.g. alternative GCs and routes of administration, and therapeutic interventions, e.g. cyclical etidronate and hormone replacement, are recommended.

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Section: The Scope Of the Problemmentioning

confidence: 99%

“…GC doses should be constantly reviewed and kept to the minimum necessary for disease control. Although inhaled GCs have less effect on bone than oral administration [17,33], alternate‐day administration does not have this advantage [78,79].…”

Section: Therapy For Gc‐induced Osteoporosismentioning

confidence: 99%

A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update

Eastell

Reid

Compston

et al. 1998

Journal of Internal Medicine

290

159

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“…Excess in glucocorticoid leads to a decrease in serum Oc levels [11, 12, 13]. Testosterone treatment in adolescent patients with hypogonadism results in an increase of the serum Oc levels [14].…”

Section: Introductionmentioning

confidence: 99%

Serum Osteocalcin and Insulin-Like Growth Factor I Levels in Children with Congenital Adrenal Hyperplasia

et al. 1999

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Patients with the virilizing forms of congenital adrenal hyperplasia (CAH) need a life-long glucocorticoid replacement therapy and also an additional mineralocorticoid replacement in cases with the salt-wasting form of the disease. Glucocorticoids are reported to decrease the serum osteocalcin levels and to inhibit the effects of insulin-like growth factor I (IGF-I). To collect data on the age related patterns of osteocalcin and IGF-I production in patients with CAH, measurements of these compounds have been carried out in a considerably large sample of treated CAH patients and control subjects in childhood and adolescence. Data of 62 patients between 0.3–19 years of age were compared to the data of 188 control children. Osteocalcin and IGF-I were determined by radioimmunoassay. A lower than normal level of serum osteocalcin was found in both male and female patients at chronological ages above 11.6 and 9.6 years, respectively. Furthermore, no pubertal osteocalcin peak could be seen when data were evaluated according to the bone age. Serum IGF-I levels were higher in male CAH patients at the chronological age of 0.3–15.5 years and in female patients at the chronological age of 4.6–9.5 years. In pubertal years serum IGF-I concentrations were lower in CAH patients when data were evaluated according to the bone age. We conclude that serum osteocalcin is decreased during and after puberty in CAH patients on replacement doses of glucocorticoids. Normal to elevated serum levels of IGF-I in treated CAH cases suggest that the shorter final height of these patients may not be due to the decreased activity in the growth hormoneIGF-I axis, but rather to the advanced bone maturation and the premature epiphyseal fusion.

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Addition of anti-leukotriene agents to inhaled corticosteroids for chronic asthma

Ducharme¹,

Hicks²,

Kakuma³

2001

The Cochrane Database of Systematic Reviews (Complete Reviews)

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Effects of inhaled corticosteroids on bone

Cited by 6 publications

References 57 publications

A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update

A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update

Serum Osteocalcin and Insulin-Like Growth Factor I Levels in Children with Congenital Adrenal Hyperplasia

Addition of anti-leukotriene agents to inhaled corticosteroids for chronic asthma

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