» Articles » PMID: 12563067

Safety Profile of Frequent Short Courses of Oral Glucocorticoids in Acute Pediatric Asthma: Impact on Bone Metabolism, Bone Density, and Adrenal Function

Overview
Journal Pediatrics
Specialty Pediatrics
Date 2003 Feb 4
PMID 12563067
Citations 15
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: Our study was designed to establish in children with asthma the safety profile of repeated short courses of oral glucocorticoids on bone mineralization and metabolism and adrenal function.

Methods: This cross-sectional study compared the bone density, bone metabolism, and adrenal function of children who were and were not exposed to bursts of oral glucocorticoids. Children were considered exposed when, in the preceding year, they received >or=2 courses of oral glucocorticoids and were prescribed the same therapy for the index exacerbation. Children were considered unexposed when they had no exposure to oral glucocorticoids and were not prescribed any for the index exacerbation. Indices of bone metabolism were measured during the subsequent month. Cortisol responses to adrenocorticotrophic hormone stimulation and bone density were assessed 30 days after the index exacerbation.

Results: Eighty-three children (48 exposed, 35 unexposed) aged 2 to 17 years were enrolled. The median exposure level was 4 courses (range: 3-11) in the preceding year. Among exposed children, a transient decrease in serum osteocalcin was observed at the end of the 5-day course with a return to baseline by 30 days; no change was observed in urine pyridinoline cross-links. Mean bone density z score was similar in the exposed (-0.61 +/- 1.0 [standard deviation]) and unexposed (-0.67 +/- 0.9) groups. No cases of abnormal response to adrenocorticotrophic hormone suggestive of adrenal insufficiency were documented in the exposed (95% confidence interval: 0%-7%) or unexposed (0%-10%) groups.

Conclusions: Repeated short courses of oral glucocorticoids in the treatment of asthma seem to be reasonably safe; this practice was not associated with any lasting perturbation in bone metabolism, bone mineralization, or adrenal function.

Citing Articles

Effectiveness of single dose oral dexamethasone versus multidose prednisolone for treatment of acute exacerbations of asthma among children.

Tayyab A, Asif A, Qazi S, Wahid S, Zafar A, Halim M Ann Med Surg (Lond). 2022; 84:104799.

PMID: 36536728 PMC: 9758287. DOI: 10.1016/j.amsu.2022.104799.


Short-course systemic corticosteroids in asthma: striking the balance between efficacy and safety.

Price D, Castro M, Bourdin A, Fucile S, Altman P Eur Respir Rev. 2020; 29(155).

PMID: 32245768 PMC: 9488828. DOI: 10.1183/16000617.0151-2019.


How can we minimise the use of regular oral corticosteroids in asthma?.

Bourdin A, Adcock I, Berger P, Bonniaud P, Chanson P, Chenivesse C Eur Respir Rev. 2020; 29(155).

PMID: 32024721 PMC: 9488989. DOI: 10.1183/16000617.0085-2019.


Management of acute respiratory diseases in the pediatric population: the role of oral corticosteroids.

Cutrera R, Baraldi E, Indinnimeo L, Miraglia Del Giudice M, Piacentini G, Scaglione F Ital J Pediatr. 2017; 43(1):31.

PMID: 28335827 PMC: 5364577. DOI: 10.1186/s13052-017-0348-x.


Efficacy of oral corticosteroids in the treatment of acute wheezing episodes in asthmatic preschoolers: Systematic review with meta-analysis.

Castro-Rodriguez J, Beckhaus A, Forno E Pediatr Pulmonol. 2016; 51(8):868-76.

PMID: 27074244 PMC: 5007060. DOI: 10.1002/ppul.23429.