Antiresorptive therapy in asthmatic patients receiving high-dose inhaled steroids: A prospective study for 18 months☆,☆☆,★,★★
Section snippets
Subjects
Patients were recruited and followed up at the Asthma Clinic at the University of Hong Kong between May 1994 and May 1997. Inclusion criteria included Chinese ancestry, age 30 to 50 years, premenopausal status, and a history of inhaled beclomethasone dipropionate or budesonide (>1.5 mg/day) therapy for at least 12 months. Exclusion criteria included chronic systemic steroid use (defined as continuous administration of oral steroids for more than 1 month in the previous 12 months); more than
RESULTS
Forty subjects were recruited (10 each of normal control subjects, patients without supplementation, patients with CaLG, and patients with CaLG plus etidronate). The results of two patients in the CaLG group were excluded from the analysis because the patients' body weight increased significantly within the study period.13 The clinical characteristics of the four groups of subjects are summarized in Tables I and II.The mean (± SEM) dosage of beclomethasone and budesonide in the three groups of
DISCUSSION
Despite the small sample size and relatively short duration of follow-up, this 18-month prospective study has provided supporting evidence for the adverse effects of inhaled steroids on bone density, previously demonstrated in cross-sectional studies. 7, 14 It has also provided evidence that such effects may be amenable to preventive measures.
In agreement with published data on steroid-induced osteoporosis,15 the reduction in BMD in the patients receiving no supplement was most obvious in the
Acknowledgements
We thank Mr. Stanley Yeung, Scientific Officer, University Department of Medicine for assistance in statistical analysis.
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2003, ChestCitation Excerpt :Differential disease severity and duration between the groups (mean FEV1, 3.34 vs 1.86 L, respectively between groups) may also have affected the results. A small clinical trial12 that was performed in China evaluated the effectiveness of antiresorptive therapy in asthmatic patients receiving high-dose ICSs. Ten healthy control subjects were recruited, and 28 asthma patients receiving an average of > 2,000 μg BDP or BUD per day were randomized to receive calcium supplementation, calcium supplementation plus etidronate, or neither.
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From the University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
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Supported by a grant from the Committee on Research and Conference Grants, and W. Q. Wang is the recipient of an Ivy Wu Fellowship of the Medical Faculty, The University of Hong Kong.
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Reprint requests: Karen S. L. Lam, MD, FRCP, University Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
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