Conde VA, Ortego CN, Callejas RJL, Mezquita RP Muñoz TM

Language: Spanish
References: 25
Page: 130-135
PDF size: 62.53 Kb.

ABSTRACT

Background: In order to minimize the side effects of corticosteroids, and in view of the efficiency of inhaled corticosteroids in asthma treatment, clinical practice guides recommend their use in ideal doses before going on to the oral route. Our hypothesis was that if patients receive oral corticosteroids before exhausting the ideal doses of inhaled corticosteroids, they will receive higher doses of accumulated corticosteroids and this will translate into diminished bone mass. Method: We studied 90 corticodependent asthmatic patients (44 premenopausal women, 27 postmenopausal and 19 men). The study included the review of the clinical history to obtain information on clinical and demographic characteristics and on the received treatment, its classification in adjusted or not to clinical practice guides and the measurement of bone mineral density in lumbar spine (LS) and femoral neck (FN). Results: Of the total population, 18.9% of patients had densitometric criteria of osteoporosis at least in one of the analyzed anatomic sites. Up to 26.7% of the population received inadequate treatment. In this group the accumulated prednisone dose was significantly higher (22.1±20.8g vs 6.4±10.6g; mean±SD); and the bone mass (Z score) in LS significantly lower (-0.49±0.80 vs –1.06±0.96; p=0.04; mean±SD); in FN, the bone mass was lower too, without reaching statistical significance (-0.42±1.0 vs -0.82±1.1; p=0.07;mean±SD). Conclusions: This study suggests that adherence of the corticosteroid treatment to the guides of clinical practice in cases of corticodependent bronchial asthma, is accompanied by a lower dose of accumulated oral corticoids and lesser loss of bone.

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