Chest
Clinical InvestigationsASTHMAEffects of Inhaled Corticosteroid and Short Courses of Oral Corticosteroids on Bone Mineral Density in Asthmatic Patients: A 4-Year Longitudinal Study
Section snippets
Subjects
Of 130 asthmatic patients who took part in our previous cross-sectional evaluation of BMD in 1993,16 17 patients were excluded based on their use of oral corticosteroids (OCSs) for≥ 3 consecutive months during the study period because of the known deleterious effects of continuous OCS treatment on bone.1624 Of the remaining 113 patients, 35 patients (15 men and 20 postmenopausal women) who visited two physicians (K.I. and B.U.) for a regular visit during the 3 months (from November 1997 to
Patient Demographic Data
The demographic data for the 35 patients participating in the second evaluation are shown in Table 1. Since the first evaluation, the average daily BDP dose had increased by 41 ± 268 μg, and the PEF values had increased by 0.9 ± 16.7% predicted.
BMD
The BMD measured at the lumbar spine on the second evaluation (0.893 ± 0.123 g/cm2) was not significantly different from baseline values (0.899 ± 0.125 g/cm2; p = 0.484). The Z score significantly increased from 95.8 ± 17.8% to 98.3 ± 18.4% (p = 0.001).
Discussion
This study investigated the effects of the long-term use of ICSs and periods of SC-OCS on lumbar BMD in asthmatic patients. The observation period (4.2 ± 0.1 years) was the longest ever among similar studies reported.181921 As a whole, BDP treatment (dose, 765 ± 389 μg/d) and SC-OCS (1.9 ± 2.7 courses per year) did not accelerate bone mass loss in the lumbar spine. Patients treated with higher doses of BDP (ie, > 1,000μ g/d) showed no difference in the change of BMD compared with patients
Acknowledgment
Authors thank Hiroyuki Otsuka for the measurement of BMDs.
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