| Autor: |
Aljubran, S. A., Whelan, G. J., Glaum, M. C., Lockey, R. F. |
| Předmět: |
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| Zdroj: |
Allergy; Nov2014, Vol. 69 Issue 11, p1429-1439, 11p, 4 Charts, 3 Graphs |
| Abstrakt: |
The effect of inhaled glucocorticosteroids (ICS) on bone metabolism and subse-quent osteoporosis is controversial. Explanations for this controversy include var-ious study designs, duration of use, outcome measures, and population demographics of research studies with intranasal or inhalational ICS. Patients with poorly controlled asthma are at greatest risk of osteoporosis because they are commonly treated with intermittent or continuous systemic corticosteroids (SCS) or high-dose ICS. A 45-year-old Caucasian woman presents with moder-ate-to-severe asthma with frequent albuterol use and nighttime awakenings at least once weekly. She is on fluticasone/salmeterol 500/50 j.ig one inhalation twice daily and montelukast 10 mg/day. She requires prednisone 15 mg three times per day for 5 days up to three times a year. Is this patient at greater risk of osteope-nia, characterized by a T-score between --1.0 and --2.5, and subsequent osteopo-rosis and an increased risk of fractures? If she has osteopenia, should she be treated with a bisphosphonate? The risk of osteoporosis and fracture increases significantly with frequent administration of SCS, and patients on such medica-tions should undergo preventative measures and treatment. This study discuses factors that contribute to an increased risk of osteoporosis/osteopenia in patients with asthma and suggests recommendations based on the current literature. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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