The effects of corticosteroids on bone growth and bone density.
OBJECTIVE
To define the effects of both parenteral and inhaled corticosteroids on bone growth in children and the development of osteopenia and osteoporosis in children and adults.


METHODS
Articles in PubMed and MEDLINE published from 1983 to 2008 were searched. Keywords used included corticosteroids and bone growth, osteopenia, osteoporosis, and bisphosphonates.


METHODS
Publications reviewed include randomized, placebo-controlled studies of both children and adults.


RESULTS
Because systemic and high-dose inhaled corticosteroids affect bone growth of children taking these medications, stadiometry should be used to measure the growth of children. Osteoporosis due to repetitive courses of oral or parenteral corticosteroids and inhaled corticosteroids can develop gradually in the aging adult. Prophylaxis against osteoporosis requires an index of suspicion, assessment of bone density, supplemental calcium and vitamin D, and use of bisphosphonates to prevent bone fractures that could compromise the patient's quality of life.


CONCLUSIONS
Preventing corticosteroid-induced effects on bone metabolism can allow effective treatment of allergic disease without long-term adverse effects.
Weldon
David
D
Department of Internal Medicine, Texas A&M University Health Sciences Center, College Station, Texas 77840, USA. dweldon@swmail.sw.org
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology*; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D002648:Child; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D000305:Adrenal Cortex Hormones