Osteoporosis in the corticosteroid-treated patient with asthma
| Autor: | Anne Manon Brenner, Barbara Lukert, Karen Prestwood, Marianne Frieri, Karen Rubin, Dennis K. Ledford, Andrea J. Apter |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Bone density Bone disease medicine.drug_class Immunology Osteoporosis Adrenal Cortex Hormones Risk Factors medicine Humans Immunology and Allergy Dosing Risk factor Dual-energy X-ray absorptiometry Asthma medicine.diagnostic_test business.industry Middle Aged medicine.disease Physical therapy Corticosteroid Female business |
| Zdroj: | Journal of Allergy and Clinical Immunology. 102:353-362 |
| ISSN: | 0091-6749 |
| Popis: | Osteoporosis affects 40% of white women older than 45 years of age and 15% of white men older than 50 years of age, resulting in approximately 1.5 million annual fractures in the United States. Systemic corticosteroid therapy increases the probability of osteoporosis, even with alternate-day dosing and with dosages sufficiently low so as not to affect the hypothalamic-pituitary-adrenal axis. Inhaled corticosteroid therapy may affect bone density if high-dose therapy is given to select individuals. The potential of increasing osteoporosis with inhaled corticosteroid asthma therapy is a concern because of the availability of more potent inhaled corticosteroid agents and recommendations that inhaled corticosteroid therapy be initiated earlier in the course of asthma. This article provides suggestions, on the basis of the medical literature and consensus of the authors when specific information was not available, for assessing and treating osteoporosis in subjects with asthma. Suggested risk categories are "low risk" (inhaled corticosteroid dosage ofor =800 microg of heclomethasone dipropionate [BDP]/day in adults oror =400 microg BDP or equivalent in children), "moderate risk" (inhaled BDP800 microg/day in adults or400 microg/day in children), and "high risk" (systemic corticosteroid therapy 4 times a year or daily or alternate-day systemic corticosteroid therapy). Dosage of nasal corticosteroid probably should be added to the orally inhaled corticosteroid for total burden of inhaled corticosteroid. Potential treatment strategies based on risk factors and bone density if indicated are offered to assist physicians treating patients with asthma. |
| Databáze: | OpenAIRE |
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