Children who used inhaled corticosteroids for asthma needn't worry about an increase risk of bone fractures
Fears inhaled corticosteroids increase the risk of fracture in children with asthma have been put to rest by an Australian study.
The study conducted at the Royal Children’s Hospital in Melbourne reassuringly found no significant increase in fracture rates in children taking inhaled corticosteroids compared with healthy children not taking this asthma medication.
The study included around 400 children between six and 18 years of age, half of whom had asthma.
Within the asthma group, children were taking low dose inhaled corticosteroids (?250µg per day) or a high dose (?250µg per day), while others had no history of taking inhaled corticosteroids.
The researchers compared the rates of fracture across all groups and found no significant differences, even after adjusting for relevant factors such as age, pubertal status, exposure to household smoking, and family history of osteoporosis.
Fracture rate was 24% in controls, 21% in asthmatic children not using inhaled corticosteroids, 24% in low-dose users of inhaled corticosteroids, and 29% in high dose users. The difference between the groups was not statistically significant.
The fact that inhaled corticosteroids did not increase fracture risk was important, the researchers said, because concerns about fractures could translate into poor prescriber adherence to treatment guidelines and poor patient compliance.
An additional finding of interest was that the majority of study participants were taking less than the daily recommended calcium intake.
“There is room for just the simple recommendation of increasing the uptake of calcium and vitamin D supplementation in paediatrics to improve bone health as a first point of call,” the authors wrote.
The researchers acknowledged that previous studies had suggested a link between inhaled corticosteroids and fractures, however, these had not included information about environmental exposure to cigarette smoke which meant their ability to control for this confounder was limited.
Long-term follow up studies into adult life were needed, they said.
Journal of Paediatrics and Child Health 2017, online 1 June
