Bone mineral density in children treated with daily or periodical inhaled budesonide: the Helsinki Early Intervention Childhood Asthma study.
In a double-blind, randomized study, 136 children, 5-10-y-old, with newly detected persistent asthma received budesonide (BUD) 400 microg twice daily for 1 mo and thereafter 200 microg twice daily for 5 mo. Thereafter, 50 children were treated with BUD 100 microg twice daily, whereas 44 children used BUD as needed for 1 y; an additional 42 children received disodium cromoglycate (DSCG). Asthma exacerbations were treated with BUD for 2 wk in a dose of 400 microg twice daily in all groups. In this secondary analysis, bone mineral density (BMD) of the lumbar vertebrae was measured before and after the 18-mo treatment. Compared with DSCG, regular BUD treatment resulted in a significantly smaller increase in BMD (0.023 versus 0.034 g/cm; p = 0.023) and height (7.75 versus 8.80 cm; p = 0.001). Periodic treatment did not affect BMD. No intergroup differences were observed when BMD data were adjusted for changes in height. Daily BUD treatment in prepubertal children may slow down the increment in BMD and standing height. This was not observed in children receiving BUD periodically after the initial regular BUD treatment. The correlation between height and BMD suggests that following children's height might afford an estimation of inhaled corticosteroid effects on bone.
Turpeinen
Markku
M
Department of Allergy, Helsinki University Central Hospital, FIN-00250 Helsinki, Finland. markku.t.turpeinen@hus.fi
Pelkonen
Anna S
AS
Nikander
Kurt
K
Sorva
Ritva
R
Selroos
Olof
O
Juntunen-Backman
Kaisu
K
Haahtela
Tari
T
D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D015519:Bone Density / Q000187:drug effects*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D019819:Budesonide / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004205:Cromolyn Sodium / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D008159:Lumbar Vertebrae / Q000033:anatomy & histology; D008297:Male
D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D019819:Budesonide; D004205:Cromolyn Sodium