Inhaled steroids, widely used to treat asthma, cause bone loss in young women. It is a fact that antiinflammatory steroids taken orally cause bone loss but prior to this study it was not clear whether inhaled steroids also caused it.
In a three-year prospective study, the researchers examined the relation between inhaled steroids and the rate of bone loss in premenopausal women with asthma. They studied 109 women, 18 to 45 years of age, at Boston's Brigham and Women's Hospital. These women had asthma and no known conditions that cause bone loss and who were treated with inhaled steroids for asthma. Bone density was measured periodically over three years.
The researchers found small yearly decreases in bone density in the hip but not the neck or the spine in those who used inhaled steroids. Those who used higher doses had more bone loss. They found a direct relation between the amount of inhaled steroids and a decrease in bone density.
However inhaled steroids are effective in treating asthma, and their use shouldn't be discouraged. But patients should try to use low doses, get sufficient calcium and vitamin D, exercise and have their bone density checked periodically. They only studied women expected similar results in men who used inhaled steroids.
NEJM; Sept 2001, Vol. 345: (13)
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