Tuesday, May 10, 2011

Intranasal Corticosteroids and Bone Mineral Density in Children

The Allergy Dude has written earlier about growth and corticosteroids, based mainly on studies from 1990-2000.  This topic is being actively investigated and within the U.S., the FDA has provided guidance as to how they recommend growth studies be done (3/07). This is quantity of bone, now how about quality of bone?

I'd like to highlight a recent article on a separate aspect of bones in children using intranasal corticosteroids (INS), which is their density, scientifically called the bone mineral density (BMD).  Do INS cause weakening of the bones in children?  Excellent question.

The Journal of Bone and Mineral Metabolism just published a study by Ozkaya E, et al. titled "Lack of bone metabolism side effects after 3 years of nasal topical steroids in children with allergic rhinitis."  The INS used was budesonide (trade name Rhinocort AQ) 1-2 puffs per day.  The subjects were 7 to 11 years old and compared to a placebo group. They concluded "long-term intermittent treatment with intranasal budesonide spray has no negative effects on BMD and associated bone health parameters."
Parents should feel reassured that high quality studies are being done and that the conclusions are most favorable.  Still my goals are to control nasal inflammation and prevent or reduce nasal symptoms on as little medication as possible.

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