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New Research - June 2010
Daily inhaled corticosteroid use may affect bone density and standing height in children
Summary
The Finnish investigators in this study enrolled 136 children 5 to 10 years of age with newly diagnosed persistent asthma into a double-blind, randomized study comparing daily budesonide, intermittent budesonide, and cromolyn sodium for the effect of these treatment regimens on bone mineral density and standing height.
All children enrolled initially received budesonide 400 mcg b.i.d. for one month, and subsequently 200 mcg b.i.d. for five months. Following this, 50 children were treated with budesonide 100 mcg b.i.d., 44 children were asked to use budesonide on a p.r.n. basis for one year, and an additional 42 children were treated with cromolyn sodium. In each group, asthma exacerbations were treated with budesonide 400 mcg b.i.d. for two weeks.
Bone mineral density was measured at the beginning and after 18 months. Budesonide treatment resulted in a smaller increase in bone mineral density and height. Intermittent, as needed treatment did not affect bone mineral density.
The authors concluded that daily budesonide treatment may slow the incremental increase in bone mineral density and standing height seen during growth.
The children treated with intermittent budesonide as needed did not experience changes in bone mineral density. Bone mineral density changes also correlated with standing height suggesting that measurement of height might offer insight into changes in bone mineral density as well.
Reference
Turpeinen M, et al. Bone mineral density in children treated with daily or periodical inhaled budesonide. The Helsinki Early Intervention Childhood Asthma (HEICA) Study. Pediatric Research, published online May 18, 2010.
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