LONGITUDINAL EVALUATION OF BONE MASS IN ASTHMATIC-CHILDREN TREATED WITH INHALED BECLOMETHASONE DIPROPIONATE OR CROMOLYN SODIUM

Inhaled corticosteroids are recommended as first-line therapy in patie nts with moderate to severe asthma. The use of these agents in the mil der form of asthma is controversial because of their potential adverse effects, especially in growing children. We investigated 49 asthmatic children (38 treated with beclomethasone dipropionate (BDP) at a dail y dose of 276+/-125 mu g/day and 11 treated with cromolyn sodium (CS) at a daily dose of 30+/-10 mg/day) for 7.4 months, with bone-mass meas urements at baseline and after the treatment period. Evaluation of cha nges in cortical and trabecular bone mass (bone mineral density [BMD]; m/cm(2)) was performed by absorptiometry at the proximal forearm and at the lumbar spine, respectively. Furthermore, to correct for bone si ze changes due to growth, we calculated volumetric BMD (VOL-BMD; mg/cm (3)). At the end of the treatment period, the children who had receive d regular inhaled BDP had grown as well as children treated with CS, f rom 120+/-1.4 to 123+/-1.3 cm and from 118+/-3.2 to 120.3+/-2.8 cm, re spectively. No children showed deviation from their percentile level o f growth. Trabecular and cortical BMD increased after 7 months of foll ow-up in both groups to the same extent. When BMD was adjusted for bod y size (VOL-BMD; mg/cm(3)), bone mass was found not to have changed af ter BDP or CS treatment course within and between the two groups.