title: Bone turnover during high dose inhaled corticosteroid treatment.
abstract: This study was performed to determine the effects of high doses of two inhaled corticosteroids, beclomethasone dipropionate and budesonide, on biochemical indices of bone turnover (urinary hydroxyproline:creatine and calcium:creatinine ratios, plasma alkaline phosphatase, and parathyroid hormone). Twelve healthy male doctors, aged 25-36 (mean 30) years, were studied. After a week's run in period eight subjects inhaled beclomethasone dipropionate 2000 micrograms/day and eight inhaled budesonide 1800 micrograms/day for 28 days; this was followed by a week without any treatment. During treatment with beclomethasone dipropionate there was a significant increase in the hydroxyproline:creatinine ratio (a 46% increase at 28 days), and a fall in serum alkaline phosphatase activity (a 7.4% fall at 28 days). There were no significant changes during budesonide treatment. Thus high dose inhaled beclomethasone dipropionate increased biochemical markers of bone resorption and reduced serum alkaline phosphatase, a marker of bone mineralisation. A prospective study in asthmatic patients is indicated to assess the long term effects of high dose inhaled corticosteroids on bone mass.
authors.affiliation: Department of Chest Diseases, University of Wales College of Medicine, Llandough Hospital, Penarth.
authors.forename: N J
authors.initials: NJ
authors.lastname: Ali
authors.forename: S
authors.initials: S
authors.lastname: Capewell
authors.forename: M J
authors.initials: MJ
authors.lastname: Ward
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D001507:Beclomethasone / Q000008:administration & dosage / Q000494:pharmacology*; D001862:Bone Resorption / Q000378:metabolism; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism*; D019819:Budesonide; D002113:Calcification, Physiologic / Q000187:drug effects; D002118:Calcium / Q000652:urine; D003404:Creatinine / Q000652:urine; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D011282:Pregnenediones / Q000008:administration & dosage / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D005938:Glucocorticoids; D010281:Parathyroid Hormone; D011282:Pregnenediones; D019819:Budesonide; D003404:Creatinine; D000469:Alkaline Phosphatase; D001507:Beclomethasone; D006909:Hydroxyproline; D002118:Calcium