Inhaled Steroids May Not Reduce Women's Bone Mass
Reuters Health

Tuesday, January 28, 2003


NEW YORK (Reuters Health) - Postmenopausal women who use inhaled steroids to control their asthma may not be increasing their risk of osteoporosis and bone fracture over the long term, new study findings suggest.

Inhaled steroids, which are among the safest and most effective treatments for persistent asthma, reduce inflammation in the airways. While steroids taken orally are known to reduce bone mass, it is unclear whether steroids taken through an inhaler, at currently recommended doses, have the same effect.

The new study found that inhaled corticosteroids were not associated with a loss of bone density in the forearms of women who were long-term users.

Dr. Solve Elmstahl, of Lund University in Malmo, Sweden, and colleagues measured bone density in the forearms of 106 postmenopausal women who had a history of using only inhaled steroids. They were compared with 674 women who had never been exposed to corticosteroids and 49 women with a history of using oral, injected and inhaled steroids.

On average, study participants had used inhaled steroids for about 8 years, according to the report in the January issue of the Journal of Allergy and Clinical Immunology.

The researchers found no difference in bone density between the inhaled-steroid group and the group with no steroid use. Women who had used oral steroids, as expected, had the lowest bone density measurements.

"Moderate doses of inhaled corticosteroids seem to carry less risk than traditional oral corticosteroid therapy provided that the dose is kept at the lowest daily dose sufficient to maintain optimum control of the disease," the authors write.

Nonetheless, Elmstahl's team notes that the number of women in the their study was small, and additional research will need to confirm or refute their findings.

According to experts, women on steroid medications can help preserve their bone mass by engaging in weight-bearing exercise and getting enough calcium and vitamin D.

SOURCE: Journal of Allergy and Clinical Immunology 2003;111:91-96.

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