SynthesisThe Cochrane database of systematic reviews2002
Inhaled corticosteroid effects on bone metabolism in asthma and mild chronic obstructive pulmonary disease.
Synthesis in The Cochrane database of systematic reviews, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 7 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Pooled it
- Beclometasone for chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2013Pooled it
- Asthma in adults.BMJ clinical evidence · 2011Pooled it
- Asthma in adults.BMJ clinical evidence · 2010Pooled it
- Clinical safety of inhaled corticosteroids for asthma in children: an update of long-term trials.Drug safety · 2006Pooled it
- Inhaled corticosteroids effects on bone in asthmatic and COPD patients: a quantitative systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2003Pooled it
- Efficacy and safety of inhaled corticosteroids in patients with COPD: a systematic review and meta-analysis of health outcomes.Annals of family medicinePooled it
- Calcitriol does not prevent bone loss in patients with asthma receiving corticosteroid therapy: a double-blind placebo-controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2006Trial
- Bone health in asthma: a twofold effect of disease and pharmacotherapy.Frontiers in endocrinology · 2026Review
- Potential Predictive of Thoracic CT Value and Bone Mineral Density T-Value in COPD Complicated with Osteoporosis.International journal of general medicine · 2024Article
- Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad?Endocrine reviews · 2023Review
- A Literature Review of the Potential Impact of Medication on Vitamin D Status.Risk management and healthcare policy · 2021Review
- Pharmacotherapy of chronic obstructive pulmonary disease: Therapeutic considerations with a focus on inhaled corticosteroids.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2020Article
- COPD and Osteoporosis: Associated Factors in Patients Treated with Inhaled Corticosteroids.International journal of chronic obstructive pulmonary disease · 2020Article
- Inhaled glucocorticoids are associated with vertebral fractures in COPD patients.Journal of bone and mineral metabolism · 2018Article
- Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update.Pharmaceutics · 2018Review
- Is Osteoporosis a Common Comorbidity in Different Chronic Airway Diseases?Tuberculosis and respiratory diseases · 2018Article
- The Skeletal Effects of Inhaled Glucocorticoids.Current osteoporosis reports · 2016Review
- Inhaled corticosteroids can reduce osteoporosis in female patients with COPD.International journal of chronic obstructive pulmonary disease · 2016Article
- Impact of treatment with inhaled corticosteroids on bone mineral density of patients with asthma: related with age.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2015Article
Corrections and comments
- Commented on by
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInhaled corticosteroids form the main therapy for asthma, but there is increasing concern about the potential systematic effects of long-term inhaled corticosteroids including their effect on bone metabolism and bone loss.
objectivesTo determine the effect of inhaled corticosteroids use on biochemical markers of bone turnover, bone mineral density and the development of fractures. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register, electronic reference databases, UK National Research Register, bibliographies of included studies, and contacted pharmaceutical companies. SELECTION CRITERIA: Randomised trials of the effect of inhaled steroid versus placebo on markers of bone function and metabolism, in adults with asthma or mild COPD. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data extracted from the papers included (2 reviewers per paper) and from additional data supplied by the authors. MAIN
resultsOf 438 references found, seven met the inclusion criteria. Three studies were in healthy subjects asthma or COPD. The patients were generally less than 60 years old and the male:female ratio was 2:1. There was no evidence of increased risk of loss of bone mineral density (BMD) or fractures. There was no significant change in osteocalcin at conventional doses of inhaled corticosteroids (Standardised Mean Difference [SMD] -0.34 (95% Confidence Interval [CI] -0.72, 0.04), although a statistically significant change was seen in those studies using experimental doses of inhaled steroid in excess of the doses recommended by the British Thoracic Society SMD 0.97 (95% CI -1.61, -0.34). A statistically significant change in parathyroid hormone seen in one small short trial (n=10, 6 weeks) may have been due to the trial design and outcome measurements used. REVIEWER'S
conclusionsIn patients with asthma or mild COPD, there is no evidence of an effect of inhaled corticosteroid at conventional doses given for two or three years on BMD or vertebral fracture. Higher doses were associated with biochemical markers of increased bone turnover, but data on BMD and fractures at these doses are not available. There is a need for further, even longer term prospective studies of conventional and high doses of inhaled corticosteroids.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.