According to Rebecca Green, M.D., Ph.D., Assistant Professor, Pediatric Endocrinology and Diabetes, Washington University School of Medicine in St. Louis, Mo., corticosteroids have long been hailed as miracle drugs for different ailments for control of symptoms when other forms of medications have failed to deliver any positive results.
These findings were concerned with the use of chronic corticosteroid at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Seattle.
From News-Medical.Net:
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.
“Analysis of large population databases has recently yielded extremely valuable data about corticosteroids and fractures, with some unexpected impact of lower doses. Analysis of the same database for inhaled steroid use in adults showed a small increase in fracture risk in users of inhaled steroids compared to control, but comparable risk of fracture in inhaled steroid users compared to individuals using inhaled bronchodilators. This suggests that the increased risk of fracture was secondary to the disease itself, not the inhaled steroids,” Dr. Green explained.
The use of inhaled corticosteroids offers a unique potential of reducing bone mineral density in male children who are in a progressive stage of puberty according to Dr. Kelly, Professor Emeritus of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, N.M. However, the associated risk is expected to outweigh by an ability to reduce oral corticosteroid quantity used in these children.
