מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Long-term therapy with an inhaled corticosteroid does not by itself increase the rate of bone mineral density (BMD) loss at the lumbar spine, according to Japanese researchers. However, patients who more frequently required short courses of an oral corticosteroid showed significantly greater loss of BMD than those who used an oral corticosteroid more sporadically.
Reporting in the November issue of Chest, Dr. Hisako Matsumoto of Kyoto University and colleagues note that previous studies of the effect of inhaled corticosteroid use on BMD have "yielded conflicting results." Furthermore, although continuous use of oral corticosteroids is a known risk factor for osteoporosis, the effect of short courses on bone loss "has not been clarified."
To investigate, the researchers studied 35 asthmatics whose lumbar BMD was established at baseline and after a mean of 4.2 years. During the study period, the subjects had a mean daily intake of inhaled beclomethasone dipropionate of 765 mcg. They also had a mean of about two short courses of oral corticosteroids per year.
In general, lumbar BMD was unchanged over the course of the study and, in fact, overall, the percentage of the normal value predicted for age and sex increased significantly.
The researchers note that this unexpected increase was particularly prominent in the 14 patients who had previously received continuous oral corticosteroid therapy (prednisolone or dexamethasone). This therapy had been discontinued more than 1.5 years before the study began because of the benefits of inhaled beclomethasone. The improvement in BMD, the researchers suggest, may have been due to "restitution of previously osteopenic bone."
The daily dose of inhaled beclomethasone had no significant effect on lumbar BMD parameters, but patients who had more than 2.5 courses of oral corticosteroids per year had a significantly greater loss of measured and predicted BMD.
Dr. Matsumoto told Reuters Health that the findings, as a whole, are reassuring. Inhaled corticosteroid use "in combination with rescue use of short courses of oral corticosteroids is safe regarding bone mass," he said, "although less frequent use of oral corticosteroids is advisable."
Another point, he added, is that it appears that loss of BMD "is reversible by switching from continuous use of oral corticosteroids to adequate use of inhaled corticosteroids."
e-Med Tools
קצר קולע וממוקד
e-Med סמינרים
אי-מד תחקירים
Medscape Tools
Journal Club
מרכזי מידע ושירות
Facebook
מידע למפרסם
מאגר תרופות
מאגר אנשי המקצוע
אינדקס שימושי
חדשות משה"ב
eMed HealthClub
מחקרים קליניים
השאירו תגובה
רוצה להצטרף לדיון?תרגישו חופשי לתרום!