OSTEOPOROSIS IN STEROID-DEPENDENT ASTHMA

Background: Patients on prolonged corticosteroid therapy are at risk o f developing osteoporosis. Some patients with severe asthma are diffic ult to wean off corticosteroids and are therefore at risk of developin g bony complications due to steroids. Objective: The purpose of this s tudy was to examine the relationship of cumulative steroid dosage and duration of therapy with osteoporosis. Methods: We obtained bone miner al density studies using dual photon absorptiometry, and radiographs o f the lumbar spine of 16 steroid-dependent patients with asthma. Patie nts with conditions affecting bone metabolism were excluded. Results: We studied 16 male steroid-dependent patients with asthma who received 4 to 41 grams equivalent dose of prednisone over a period of 1 to 15 years. The overall prevalence rate for abnormal age-matched bone miner al density was 50%. Abnormal bone mineral density was more commonly no ted in the lumbar spine (38%) than in the femoral neck (19%). The lowe st dose of corticosteroid associated with a decrease in bone mineral d ensity was a cumulative steroid dose of 5.6 equivalent grams-prednison e. Conclusion: Prolonged corticosteroid therapy can cause significant osteoporosis among male patients with steroid-dependent asthma. Bone l oss due to corticosteroid therapy occurs at different rates at differe nt bony sites.