Pharmacology
Inhaled corticosteroids shown to reduce bone density
By Pankaj, US correspondent
Dec 16, 2004, 16:41

Study participants with mild to moderate chronic obstructive pulmonary disease (COPD) who used 1,200 micrograms per day over 3 years of an inhaled corticosteroid, triamcinalon, in an attempt to slow lung function decline showed reduced bone density in both the lumbar spine and neck of the femur (thigh). The researchers investigated bone metabolism in COPD in 412 subgroup participants involved in Lung Health Study II. All subjects, who were either current smokers or recent quitters, underwent bone mineral density scans of the hip and lumbar spine with dual-energy X-ray absorptiometry at the start of the study, after 1 year, and at the end of year 3. (In COPD, patients have persistent obstruction of the airways associated with either emphysema or chronic bronchitis, caused by years of smoking.) The reductions were 1.78 percent in femoral neck bone mass density and 1.33 percent in lumbar spine bone mass density.

The declines occurred in both the men and women patients who were from 55 to 57 years old. Good adherence to therapy (more than 9 puffs of inhaled corticosteroid per day over 3 years) was seen in almost 47 percent of the patients. The authors said that there was little or no decline in bone mass density until after the first year of the study, but reductions did occur during the second and third years of the trial. Since smoking prevalence is high in persons with COPD, the authors urged doctors to encourage patients to quit.

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