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Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis.

Loke YK, Gilbert D, Thavarajah M, Blanco P, Wilson AM - BMJ Open (2015)

Bottom Line: Three RCTs and three observational studies in children reported on bone mineral density at the lumbar spine, and our meta-analysis did not show significant reductions with ICS use.Three RCTs and four observational studies in adults reported on ICS use and bone mineral density at the lumbar spine and femur, with no significant reductions found in the meta-analysis compared to control.ICS use for ≥12 months in adults or children with asthma was not significantly associated with harmful effects on fractures or bone mineral density.

View Article: PubMed Central - PubMed

Affiliation: Norwich Medical School, University of East Anglia, Norwich, UK.

No MeSH data available.


Related in: MedlinePlus

BMD in lumbar spine children, ICS use versus non-use. BMD, bone mineral density; ICS, inhaled corticosteroids.
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BMJOPEN2015008554F3: BMD in lumbar spine children, ICS use versus non-use. BMD, bone mineral density; ICS, inhaled corticosteroids.

Mentions: Three RCTs and three observational studies reported on comparative change at the lumbar spine in children.151920222325 (figure 3) ICS use was not associated with significant reductions in BMD as compared to controls in RCTs (mean difference −0.0018 g/cm2; 95% CI −0.0051 to 0.0015 g/cm2; I2=46%) or observational studies (mean difference −0.0075 g/cm2; 95% CI −0.044 to 0.028 g/cm2; I2=42%). There was no clear signal of dose responsiveness in one observational study that separated participants into different dose levels,25 whereas one RCT suggested that longer term users of budesonide with greater cumulative doses had lower BMD compared to those who received lower cumulative doses.20


Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis.

Loke YK, Gilbert D, Thavarajah M, Blanco P, Wilson AM - BMJ Open (2015)

BMD in lumbar spine children, ICS use versus non-use. BMD, bone mineral density; ICS, inhaled corticosteroids.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663435&req=5

BMJOPEN2015008554F3: BMD in lumbar spine children, ICS use versus non-use. BMD, bone mineral density; ICS, inhaled corticosteroids.
Mentions: Three RCTs and three observational studies reported on comparative change at the lumbar spine in children.151920222325 (figure 3) ICS use was not associated with significant reductions in BMD as compared to controls in RCTs (mean difference −0.0018 g/cm2; 95% CI −0.0051 to 0.0015 g/cm2; I2=46%) or observational studies (mean difference −0.0075 g/cm2; 95% CI −0.044 to 0.028 g/cm2; I2=42%). There was no clear signal of dose responsiveness in one observational study that separated participants into different dose levels,25 whereas one RCT suggested that longer term users of budesonide with greater cumulative doses had lower BMD compared to those who received lower cumulative doses.20

Bottom Line: Three RCTs and three observational studies in children reported on bone mineral density at the lumbar spine, and our meta-analysis did not show significant reductions with ICS use.Three RCTs and four observational studies in adults reported on ICS use and bone mineral density at the lumbar spine and femur, with no significant reductions found in the meta-analysis compared to control.ICS use for ≥12 months in adults or children with asthma was not significantly associated with harmful effects on fractures or bone mineral density.

View Article: PubMed Central - PubMed

Affiliation: Norwich Medical School, University of East Anglia, Norwich, UK.

No MeSH data available.


Related in: MedlinePlus