Obstructive Lung Diseases: Asthma Guidelines and Outcomes |

Effect of Inhaled Corticosteroids on Bone Mineral Density in Indian Patients Having Bronchial Asthma FREE TO VIEW

Sudhir Agarwal, MD; Ashish Singh, MBBS
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Institute of Medical Sciences, Varanasi, India

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):889A. doi:10.1016/j.chest.2016.08.989
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SESSION TITLE: Asthma Guidelines and Outcomes

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 23, 2016 at 07:30 AM - 08:30 AM

PURPOSE: The purpose of the study was to see the effect of inhaled corticosteroids (ICS) used in low doses, medium doses and high doses on bone mineral density (BMD) in Indian patients having bronchial asthma.

METHODS: This study was conducted on 100 patients with the diagnosis of bronchial asthma. Patients below 18 years of age, having unstable medical or psychiatric conditions, using systemic corticosteroids, post-menopausal females and who had known factors affecting BMD were excluded from the study. We took patients medical history and performed routine investigations along with pulmonary function test with reversibility. Dual-Energy X-ray Absorptiometry (DEXA) scan of lumbar spine was used to measure the BMD. The WHO classification of T-score was used for osteopenia and osteoporosis . Grouping of patients was done on the basis of dose of ICS they used (low-dose ICS, medium-dose ICS and high-dose ICS group).

RESULTS: The means of T-score of low- dose ICS, medium- dose ICS and high- dose ICS group were -0.56±0.16, -1.15±0.72 and -1.54±0.57 respectively. The median of T-score of low- dose ICS, medium- dose ICS and high- dose ICS group were -0.60 (-0.75 − -0.40), -1.20 (-1.75 − -0.80) and -1.60 (-2.00 − -0.20) respectively. A significant positive correlation was found between the duration of use of medium- dose and high- dose ICS and T-score (p<0.001). Correlation between duration of low- dose ICS and T-score was not significant (p=0.637).

CONCLUSIONS: From our study we concluded that BMD was not significantly reduced in bronchial asthma patients using low- dose ICS. However, there was significant reduction in BMD when ICSs were used in medium-dose (for >4 years) and high-dose (for >1 year).

CLINICAL IMPLICATIONS: Low-dose ICS seems to be safe in Indian patients having bronchial asthma. However, because of reduction in BMD by moderate to high doses of inhaled steroids it should be used with caution in asthmatics.

DISCLOSURE: The following authors have nothing to disclose: Sudhir Agarwal, Ashish Singh

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