Bone Loss Linked to Inhaled Steroids in Women with Asthma

Women with asthma who take commonly prescribed inhaled steroids are at greater risk of experiencing bone loss in their hips and subsequently, osteoporosis, according to a study in today's New England Journal of Medicine. The AP/Akron Beacon Journal reports that researchers at Brigham and Women's Hospital in Boston found that inhaled steroids have a similar effect on healthy, pre-menopausal women in promoting bone loss as do steroids taken in pill form -- a conclusion that researchers say should lead doctors who treat the millions of Americans with asthma to re-evaluate the use of inhaled steroids and consider supplemental treatments (Nano, AP/Akron Beacon Journal, 9/27). In the study, researchers examined 109 women between the ages of 18 and 45 who were divided into three groups: those taking four to eight puffs of glucocorticoids a day, those taking more than eight puffs, and those not using steroid inhalers (Barnard, Boston Globe, 9/27). After measuring bone density at intervals of six months, one year, two years and three years, the researchers found that those taking the higher dose of the steroid suffered a greater bone loss in their hips (Reuters/New York Times, 9/27). The hip area is "the most vulnerable spot for fractures associated with osteoporosis," which affects 28 million Americans and causes 300,000 bone fractures a year, the Boston Globe reports.

Inhaled steroids have become popular among asthma patients because they both prevent attacks and relieve symptoms, and because they were thought to reduce the risk of bone reduction seen in steroid pills. Dr. Elliot Israel, an allergist at Brigham & Women's and the study's lead author, said the results "do not mean that" women with asthma should stop taking inhaled steroids -- instead, doctors should adhere more closely to national guidelines stating that glucocorticoids should be used to get the lung condition "under control" and then should be reduced to the "lowest possible dose" (Boston Globe, 9/27).