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Little Risk of Bone Loss From Long-Term Use of Budesonide, Meta-Analysis Shows: Presented at ERS By Cameron Johnston COPENHAGEN, DENMARK -- September 20, 2005 -- The long-term impact of inhaled corticosteroids on bone mineral density (BMD) is a serious concern for patients with asthma and chronic obstructive pulmonary disease (COPD). However, results of a large meta-analysis suggest that the long-term use of budesonide does not pose any serious risks of bone loss. Soren Pedersen, MD, professor, department of pediatrics, Kolding Hospital, Kolding, Denmark, presented the results of the study here on September 19th at the European Respiratory Society 15th Annual Congress (ERS). The study was a meta-analysis of 12 papers published between 1992 and 2004 involving adults and children with asthma and 2 papers involving patients with COPD. Doses of budesonide used in the studies were 200 to 400 mcg/day for children and 400 to 800 mcg/day for adults. The studies ranged from 1 to 6 years in duration. Readings for BMD were taken with single or dual energy x-ray absorptiometry. The change in BMD in 1041 children aged 5 to 12 years treated with budesonide 400 mcg/day did not differ from measurements seen in children treated with either a placebo or nedocromil 8 mg/day. Changes in BMD were all in the order of 0.15 gr/cm2. The researchers noted an increase in total body BMD of 2.5% after 12 months of therapy with budesonide or nedocromil. Among 374 adults using either budesonide at a mean dose of 389 mcg/day, beclomethasone 499 mcg/day via metered dose inhaler, or other agents that were not based on inhaled corticosteroid, there were no significant differences in lumbar or femoral BMD after 2 years of therapy. However, the estimated loss in BMD after 3 years of high-dose budesonide 800 mcg/day was 1.62% at the femoral trochanter and a loss of 1.67% at Ward's triangle. The losses in BMD at the femoral neck and the 2-4 lumbar vertebrae were 0.87 and 0.52, respectively. The authors said there were some limitations to the study, but on the whole, these data suggest that long-term use of budesonide in either adults or children has no deleterious impact on BMD. More studies are needed to determine what the results might be among patients using higher doses of these drugs. The study was funded by AstraZeneca. [Presentation title: Bone Mineral Density and Inhaled Budesonide -- a Systematic Review of Long-Term Treatment in Children and Adults. Poster 1856] E-mail this page to a friend or colleague! To print, use this version