RT Journal Article
SR Electronic
T1 Bone mineral density in patients with chronic obstructive pulmonary disease treated with budesonide Turbuhaler®
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1058
OP 1063
DO 10.1183/09031936.02.00276602
VO 19
IS 6
A1 Johnell, O.
A1 Pauwels, R.
A1 Löfdahl, C-G.
A1 Laitinen, L.A.
A1 Postma, D.S.
A1 Pride, N.B.
A1 Ohlsson, S.V.
YR 2002
UL https://publications.ersnet.org//content/19/6/1058.abstract
AB There is a need for studying the effects of long-term inhaled corticosteroid therapy on bone mineral density (BMD) and vertebral fracture rates in patients with mild chronic obstructive pulmonary disease (COPD). Patients (n=912, mean age 52 yrs) with mild COPD (mean forced expiratory volume in one second (FEV1) 77% of predicted; mean FEV1/slow vital capacity ratio 62%) were randomized to receive budesonide 400 µg, or placebo twice daily via Turbuhaler®. BMD was measured at the L2–L4 vertebrae and the femoral neck, trochanter and Ward's triangle by dual-energy X-ray absorptiometry at baseline and after 6, 12, 24 and 36 months (n=161). Radiographs of the thoracic and lumbar spine were obtained at the beginning and end of treatment (n=653). Previous fractures were present at baseline in 43 budesonide-treated patients (13.4%) and 38 placebo-treated patients (11.5%). New fractures occurred in five budesonide-treated patients, compared with three in the placebo group (p=0.50). There were no significant changes in BMD at any site in budesonide-treated patients, compared with the placebo group, during the course of the study. Budesonide treatment was associated with a slight but statistically significant decrease in the area under the concentration-time curve for serum osteocalcin. In the present study, involving a large group of patients with chronic obstructive pulmonary disease, long-term treatment with budesonide 800 µg·day−1 via Turbuhaler® had no clinically significant effects on bone mineral density or fracture rates. This study was supported by AstraZeneca Research and Development Lund, Lund, Sweden.