Inhaled Steroids Don't Contribute to Bone Fracture in Children
A study out of The Hospital for Sick Children in Toronto (colloquially—and on brand! —known as SickKids) has determined that children who take inhaled corticosteroids (ICS) for asthma are not at greater risk for bone fractures than kids not on the anti-inflammatory medication for asthma. 1
This is great news.
It can be difficult for parents to put their children on long-term medicines and have to worry about potential consequences—even when they know the risk of uncontrolled asthma is much greater than most side-effects. While inhaled corticosteroids are generally safe, they do have side-effects that may concern parents. Being assured fracture is one less risk children are facing may help parents stay on top of their children’s medications and avoid non-adherence or discontinuation of inhaled corticosteroids—which should be taken daily to keep asthma under control.
An “on the side” finding of the research done by Dr. Teresa To and team determined "nearly 50% of children with asthma did not fill a prescription for an inhaled corticosteroid during the study period.”1
As inhaled corticosteroids are generally safe, it is possible parents did not fill these medications for a variety of reasons. These reasons could include not understanding the purpose of the medicine, lack of education about the importance of these medications on a regular basis, not wanting their child on long-term medication, or not being able to afford medications. As well, if parents feel there is not enough research done on potential side-effects—especially those that may impact a child long-term, such as osteoporosis, fracture, and bone loss—they also may be more hesitant to maintain children on these medications.
More research needs to be done
Hopefully, the research presented here that children who take inhaled corticosteroids are no more susceptible to fractures than their peers is one more reassurance for parents to maintain their child on medicine as prescribed.
The article noted more research needs to be done to determine if asthma severity—and in turn, required ICS dose—has relevance to rates of fracture in children. 1 It is also noted in the abstract that systemic (oral) corticosteroids (OCS)—but not ICS—are linked to increased risk of fracture. 2 There is generally a greater side-effect profile associated with oral corticosteroids, given the systemic nature of OCS.
Parents should feel reassured inhaled corticosteroids are safe medicines, however, they should speak to their child’s doctor or clinic nurse if they have concerns about their child’s treatment or potential for side effects.
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