{"id":26492,"date":"2020-10-24T06:50:44","date_gmt":"2020-10-24T06:50:44","guid":{"rendered":"https:\/\/bengalnewstimes.com\/?p=26492"},"modified":"2020-10-24T06:50:44","modified_gmt":"2020-10-24T06:50:44","slug":"could-common-asthma-meds-weaken-bones","status":"publish","type":"post","link":"https:\/\/bengalnewstimes.com\/?p=26492","title":{"rendered":"Could Common Asthma Meds Weaken Bones?"},"content":{"rendered":"

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\"NewsBy Amy Norton<\/b>
HealthDay Reporter<\/i><\/p>\n

THURSDAY, Oct. 22, 2020 (HealthDay News)<\/p>\n

People who use common asthma<\/a> controller medications are vulnerable to developing brittle bones and suffering fractures<\/a>, a new study shows.<\/p>\n

The findings point the finger at anti-inflammatory corticosteroids<\/a> — whether taken by pill or inhaler.<\/p>\n

Corticosteroids<\/a> are widely used to prevent asthma<\/a> attacks, particularly in the form of inhalers. When asthma<\/a> is more difficult to control, oral versions of the medications may be prescribed for a time.<\/p>\n

It has long been known that oral corticosteroids — especially at high doses — can lower bone density<\/a>. And some evidence has suggested inhaled versions can do the same.<\/p>\n

No one, however, is saying people with asthma<\/a> should abandon their controller medications.<\/p>\n

“Inhaled corticosteroids play a crucial role in the control of airway<\/a> inflammation in asthma<\/a>,” said lead researcher Christos Chalitsios. “Patients with asthma<\/a> should not stop using their inhalers.”<\/p>\n

But doctors should prescribe corticosteroids at the lowest dose needed to control the disease, said Chalitsios, a research assistant and PhD candidate at the University of Nottingham School of Medicine, in the United Kingdom.<\/p>\n

The findings are based on medical records for nearly 3,700 older adults with asthma and either osteoporosis<\/a> or a history of bone fracture<\/a>. Each was compared with at least four other patients the same age who had asthma, but no bone disease.<\/p>\n

Overall, the study found, the risk of bone trouble climbed along with the number of steroid prescriptions patients had in the past year.<\/p>\n

Those with four or more prescriptions for an oral corticosteroid<\/a> were about four times more likely to have osteoporosis<\/a>, versus those with no prescriptions. The risk of a bone fracture<\/a> was doubled when patients had nine or more prescriptions.<\/p>\n

Meanwhile, inhaled steroids were also linked to fragile bones, though to a lesser degree, the investigators found.<\/p>\n

Patients using inhalers were 35% to 60% more likely to have osteoporosis<\/a>, versus non-users. And the risk of bone breaks started to rise once patients had more than six prescriptions for the year — by as much as 31% among those with 11 or more prescriptions.<\/p>\n

The findings, which did not prove that steroids actually cause osteoporosis<\/a> or fractures<\/a>, were published online Oct. 20 in the journal Thorax<\/i>.<\/p>\n

Asthma specialists not involved in the study said it gives support to something that’s been suspected: Inhaled corticosteroids, too, may eventually weaken the bones.<\/p>\n

But that does not mean patients should stop them.<\/p>\n

“We have very good data showing inhaled corticosteroids improve control of asthma,” said Dr. Megan Conroy, a pulmonologist<\/a> at Ohio State University’s Wexner Medical Center, in Columbus.<\/p>\n

“And that reduces the likelihood of patients needing oral corticosteroids,” she pointed out.<\/p>\n

Instead, Conroy said, doctors should talk to patients about ways to protect their bone health. In general, experts recommend getting adequate calcium and vitamin D<\/a>, as well as regular weight-bearing exercise<\/a>, including walking<\/a>, climbing stairs and training with weights.<\/p>\n

It’s not clear exactly “how much” vitamin D<\/a> and calcium patients need to help counter medication effects, according to Dr. Louis DePalo. At a minimum, he said, they should be sure they are not deficient in vitamin D<\/a>, which can be gauged with a blood test.<\/p>\n

DePalo is system clinical director of the Mount Sinai-National Jewish Respiratory Institute, in New York City.<\/p>\n

With his own patients who are long-time corticosteroid<\/a> users, DePalo also suggests starting bone-density screening at an earlier age than is generally recommended (age 65 for women).<\/p>\n


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QUESTION<\/h4>\n


\n Asthma is a chronic respiratory disease. <\/span>
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“And then I have to make the argument to the insurance company, who wants to know why this 40-year-old is being screened,” DePalo said. “Studies like this can help me make that argument.”<\/p>\n

Patients’ exposure to corticosteroids can also be minimized by “stepping down” their dose, Conroy said. That’s an option for people whose asthma is well-controlled by their inhaler medication.<\/p>\n

If, on the other hand, the asthma is so severe that oral corticosteroids are being repeatedly used, it might be time for a switch, according to Conroy. Newer “biologic” drugs<\/a>, given by injection, could be an option, she said.<\/p>\n

Chalitsios said some patients may also benefit from medications that protect bone density<\/a>, called bisphosphonates. His team found that many patients were not on those medications in the year leading up to their osteoporosis<\/a> diagnosis or bone fracture<\/a>: Even among patients frequently prescribed oral corticosteroids, only half were also prescribed a bisphosphonate.<\/p>\n

\"MedicalNews\"
Copyright \u00a9 2020 HealthDay. All rights reserved.<\/p>\n


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From \"WebMD<\/h3>\n
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Health Solutions From Our Sponsors<\/span><\/h5>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n

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References<\/p>\n


\n SOURCES: Christos Chalitsios, MSc, PhD candidate, research assistant, School of Medicine, University of Nottingham, Nottingham, U.K.; Megan Conroy, MD, pulmonologist, The Ohio State University Wexner Medical Center, Columbus, Ohio; Louis DePalo, MD, professor, pulmonary, critical care and sleep medicine, Icahn School of Medicine at Mount Sinai, and system clinical director, Mount Sinai-National Jewish Respiratory Institute, New York City; Thorax<\/i>, Oct. 20, 2020, online \n <\/p>\n<\/p><\/div>\n