TY - JOUR T1 - Prospective follow-up of novel bone turnover markers in asthmatics exposed to low or high doses of inhaled ciclesonide over 1 year JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2100 AU - William Anderson AU - Lesley McFarlane AU - Brian Lipworth Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2100.abstract N2 - BACKGROUND: There is concern that asthmatics receiving long-term inhaled corticosteroids could develop systemic adverse effects on bone metabolism. We investigated if exposure to inhaled ciclesonide at high vs low doses over 1 year caused any adverse effects on sensitive biomarkers of bone turnover in asthmatics.METHODS: Post hoc analysis of stored bone marker samples in a subgroup from a prospective, randomised parallel group trial (Lipworth et al. Chest DOI:10.1378/chest.11-1748) where ciclesonide was titrated to control asthma against either mannitol airway hyper-responsiveness (AHR strategy) or control (based on symptoms, reliever use and lung function) over 1 year. 100 mild-moderate asthmatics, 18-65years, with AHR to mannitol challenge had bone marker samples available for analysis. Outcome measures: bone formation (PINP, PIIINP), resorption (ICTP, CTx) and adrenal suppression (overnight urinary cortisol/creatinine: OUCC) at 0 and 12 months.RESULTS: Mean ciclesonide doses after 12 months were: AHR=507µg/day (n=50); control=202 µg/day (n=50), p<0.0001. There were no significant differences between AHR and control groups at baseline or after 12 months in PINP, PIIINP, ICTP or CTx; ratios of bone turnover as PINP/ ICTP; PIIINP/CTx; or OUCC.CONCLUSION: Higher doses of inhaled ciclesonide do not adversely affect sensitive markers of bone turnover in asthmatics over 12 months. ER -