title: Effect of inhaled steroids on bone mineral density: a meta-analysis.
abstract: Inhaled corticosteroids are currently considered first-line agents for the treatment of asthma. Medium- to long-term administration of inhaled steroids may be associated with bone loss. Various studies have evaluated their effect on bone mineral density (BMD); some have shown loss of BMD with steroid treatment, but others have failed to do so. The present meta-analysis was undertaken to determine the possible effect of inhaled steroids on bone density. Literature was collected using computerized (MEDLINE) and manual searches using index medicus and checking cross-references of the published articles. The studies identified were screened for inclusion/exclusion criteria. Grouped means (XT/XC) and pooled standard deviations (SDT/SDC) for the treatment group (XT[95% CI] = 1.144 [1.019-1.269]; SDT = 0.163, g/cm2) and control group (XC [95% CI] = 1.193 [1.073-1.313]; SDC = 0.157, g/cm2) were worked out respectively for the selected studies. Finally, a comparison between grouped means of steroid-treated and control groups was done by two-sample t-test at the 5% level of significance. The results of the meta-analysis showed that although the mean BMD of the steroid-treated group was reduced by 4.1% as compared to the control group, this failed to achieve statistical significance (p = 0.8; 95% CI for the mean difference between two groups = 0.028-0.070 g/cm2). It is concluded that inhaled steroids for the treatment of asthma can be considered safe with respect to their effect on bone loss.
authors.affiliation: Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Sharma
authors.forename: Samir
authors.initials: S
authors.lastname: Malhotra
authors.forename: Promila
authors.initials: P
authors.lastname: Pandhi
authors.forename: Narinder
authors.initials: N
authors.lastname: Kumar
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000494:pharmacology*; D015519:Bone Density / Q000187:drug effects*; D006801:Humans
chemical_list: D000305:Adrenal Cortex Hormones