Cookie Notice

This site uses cookies. By continuing to browse this site, you are agreeing to our use of cookies. Review our cookies information for more details.

OK
skip to main content

Asthmatics on corticosteroids face elevated osteopenia/osteoporosis risk: a 5-year study

Published online October 24, 2024

Oral corticosteroid (OCS) and inhaled corticosteroid (ICS) are medications frequently used in the management of asthma. High-dose and long-term use of corticosteroids often raise concerns about multiple adverse effects including osteoporosis. However, studies on the long-term effects of ICS/OCS on osteoporosis have shown mixed results about the extent of this risk.

The recent publication by Chang and Jeon et al. in The Journal of Allergy and Clinical Immunology: In Practice investigated electronic health records from Ajou University Medical Center (Korea) retrospectively. Adult asthmatics receiving maintenance ICS with/without OCS for at least 1 year were classified into the high- and low-dose ICS or OCS groups. Primary outcomes, including incidences of osteoporosis, osteopenia, and fractures, and secondary outcomes, including drug prescription and laboratory values related to bone metabolism, were compared after 5 years of follow-up.

With 468 patients enrolled in each high- and low-dose OCS group, the risk of osteoporosis/fracture was higher in the high-dose OCS group (especially in females aged ≥50 years, who have high risk of osteoporosis). Although the comparison of 1,252 patients in the high- and low-dose ICS groups did not show differences in the risk of osteoporosis, the risk of osteopenia was higher in the high-dose ICS group. Additionally, analysis of laboratory values showed significantly decreased serum albumin and increased ALP in the high-dose OCS group compared to the low-dose OCS group. These results suggest that long-term use of OCS can increase the risk of osteoporosis, while long-term use of ICS may increase the risk of osteopenia in adult asthmatics. Clinicians should be aware of bone-related adverse effects and carefully monitor patients’ bone health when managing asthmatics under long-term use of ICS/OCS.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

Full Article