Effects of inhaled budesonide on serum markers of bone metabolism in children with asthma

Sorva, Ritva; Turpeinen, M.; Juntunen‐Backman, Kaisu; Karonen, Sirkka-Liisa; Sorva, Antti

doi:10.1016/0091-6749(92)90106-c

Cited by 107 publications

(49 citation statements)

References 35 publications

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“…Several studies on procollagen levels in serum and blister fluid of the skin have shown decreased procollagen levels during ICS treatment (5,6,20,21,23). Furthermore, decreased procollagen levels have been shown to be associated with dermal thinning (6).…”

Section: Discussionmentioning

confidence: 99%

Skin Thickness in Children Treated With Daily or Periodical Inhaled Budesonide for Mild Persistent Asthma. The Helsinki Early Intervention Childhood Asthma Study

et al. 2010

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ABSTRACT:In adults, asthma treatment with high doses of inhaled corticosteroids has resulted in dermal thinning. The aim of this study was to investigate the skin thickness in children with asthma during budesonide treatment. In a double-blind study, 113 children, 5-10 y old, with persistent asthma received budesonide 400 g twice daily for 1 mo and thereafter 200 g twice daily for 5 mo. Thereafter, 56 children received 100 g twice daily for 1 y, whereas 57 other children used budesonide periodically for exacerbations. An additional 54 children were treated with disodium cromoglycate (DSCG) for 18 mo. Skin thickness was measured on each forearm before and after treatment for 6, 12, and 18 mo using a 20-MHz high-resolution ultrasonic device. The initial 6-mo budesonide treatment resulted in a greater reduction in mean skin thickness in the forearms compared with DSCG (right: Ϫ35.9 versus Ϫ5.9 m; p ϭ 0.004; left: Ϫ30.6 versus Ϫ7.3 m; p ϭ 0.03). At month 18, the inter-group differences were no longer significant. Budesonide inhalations in daily doses of 400 -800 g in prepubertal children with newly detected asthma may cause minor dermal thinning. The changes were reversible during low dose or periodic treatment with budesonide. (Pediatr Res 67: 221-225, 2010)

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Section: Discussionmentioning

confidence: 99%

Skin Thickness in Children Treated With Daily or Periodical Inhaled Budesonide for Mild Persistent Asthma. The Helsinki Early Intervention Childhood Asthma Study

et al. 2010

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“…Inhaled corticosteroid treatment may be associated with normal or reduced bone mass in children [3,4,5,6,7,8,9,10,11,12]. Suppression of bone turnover has been demonstrated only for some markers of formation and resorption in children receiving inhaled steroids [13,14,15,16]. Skeletal growth is suppressed by high doses of inhaled steroids [17].…”

Section: Introductionmentioning

confidence: 99%

Are inhaled corticosteroids associated with an increased risk of fracture in children?

et al. 2004

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Inhaled corticosteroids are widely used in the long-term management of asthma in children. Data on the relationship between inhaled corticosteroid therapy and osteoporotic fracture are inconsistent. We address this issue in a large population-based cohort of children aged 4-17 years in the UK (the General Practice Research Database). The incidence rates of fracture among children aged 4-17 years taking inhaled corticosteroids (n=97,387), taking bronchodilators only (n=70 984) and a reference group (n=345,758) were estimated. Each child with a non-vertebral fracture (n=23,984) was subsequently matched by age, sex, practice, and calendar time to one child without a fracture. Fracture incidence was increased in children using inhaled corticosteroids, as well as in those receiving bronchodilators alone. With an average daily beclomethasone dose of 200 lg or less, the crude fracture risk relative to nonusers was 1.10 [95% confidence interval (CI), 0.96-1.26]; with dosage of 201-400 lg, it was 1.23 (95% CI, 1.08-1.39); and with dosages over 400 lg, it was 1.36 (95% CI, 1.11-1.67). This excess risk disappeared after adjustment for indicators of asthma severity. The increased risk of fracture associated with use of inhaled corticosteroids is likely to be the result of the underlying illness, rather than being directly attributable to inhaled corticosteroid therapy.

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“…Indices of bone formation, such as alkaline phos phatase (AP) or the bone-specific isoenzyme of AP, were not altered by ICS in most studies [25][26][27][28][29][30][31]. Only in the study of A li et al were changes found [32].…”

Section: Side-effects: General Considerationsmentioning

confidence: 91%

“…2) [21,[25][26][27][28][29][30][31][35][36][37][38]. Os teocalcin is a very sensitive marker of osteoblast activity, as most serum osteocalcin originates from new cellular synthesis [34].…”

Section: Side-effects: General Considerationsmentioning

confidence: 99%

Effects of inhaled corticosteroids on bone

Bootsma

Dekhuijzen

Festen

et al. 1997

The Netherlands Journal of Medicine

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Inhaled corticosteroids (ICS) are the most effective therapy for asthma currently available. The increasing use of ICS raises the issue of possible adverse systemic effects. Since one of the most important side-effects of oral corticosteroids (OCS) is osteoporosis, this article focuses on current knowledge of the effects of ICS on bone. Generally, doses higher than 1.0 mg/day cause a dose-dependent decrease in serum osteocalcin levels. Decreases in bone density have been suggested after treatment with ICS, but in most studies it is impossible to quantify the contribution of previous treatment with OCS and other confounding factors to bone loss. The clinical relevance of the observed changes in the long term is unknown. To date,

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Effects of inhaled budesonide on serum markers of bone metabolism in children with asthma

Cited by 107 publications

References 35 publications

Skin Thickness in Children Treated With Daily or Periodical Inhaled Budesonide for Mild Persistent Asthma. The Helsinki Early Intervention Childhood Asthma Study

Skin Thickness in Children Treated With Daily or Periodical Inhaled Budesonide for Mild Persistent Asthma. The Helsinki Early Intervention Childhood Asthma Study

Are inhaled corticosteroids associated with an increased risk of fracture in children?

Effects of inhaled corticosteroids on bone

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