According to a recent analysis of large population databases, there is some unexpected impact on bones after corticosteroids have been administered to patients suffering from asthma.
For long, corticosteroids have been considered to be “miracle drugs“, which have been successful even for ailments where no other medications had succeeded before.
According to Rebecca Green, M.D., Ph.D., assistant professor, pediatric endocrinology and diabetes, Washington University School of Medicine in St. Louis, Mo., important side effects have emerged along with the benefits of high dose corticosteroids.
From News-Medical.Net:
Inhaled corticosteroids are one of the most effective medications for controlling asthma. These anti-inflammatory medications reduce swelling in the airways, improve lung function and act to prevent asthma episodes or “asthma attacks.” Intervention with inhaled corticosteroids can improve asthma control and reduce emergency department visits, hospitalization and deaths.
The side effects attributed to corticosteroids include decreased bone mineral density and reduced bone mass, and also in children, reduced growth rate. According to Dr. Green, strategies to alleviate these effects include minimizing oral doses and adding topical or inhaled steroids to provide the same anti-inflammatory benefit in the areas affected by inflammation while avoiding systemic effects. Disturbance in bone acquisition in childhood can reduce peak bone mass and therefore significantly impact the life time risk of osteoporosis.
“One of the challenges has been distinguishing the effects of the inflammatory process itself on bone mass and growth, and the effects of corticosteroids on bone growth from the effects of corticosteroids on bone mass,” she said.
Dr. Kelly, professor emeritus of pediatrics, University of New Mexico Health Sciences Center, Albuquerque, N.M., remarked that some risk associated with use of inhaled corticosteroids can be very easily outweighed by the ability to minimize the amount of oral corticosteroids used in children.
