Regular steroid users need osteoporosis check

NEW YORK (Reuters Health) - People who regularly take high-doses of steroids for asthma or other conditions do not appear to be properly screened and followed for the bone-thinning disease osteoporosis and other harmful effects of these drugs on bone health, researchers warn.

"Increased risk of osteoporotic fracture, a well-recognized adverse effect of high-dose corticosteroid exposure, has focused attention on exposure to orally administered corticosteroid drugs," Dr. Maggie Che, of Kaiser Permanente Medical Center, Vacaville, California, and colleagues write in the Annals of Allergy, Asthma and Immunology.

"Our review of the medical literature and the results of this study show a currently unmet need to protect a large number of adults from the potentially adverse skeletal effects of high-dose oral and inhaled corticosteroid drugs," they add.

The researchers examined high-dose steroid use, osteoporosis screening and treatment trends in 18,737 people taking high-dose oral or inhaled corticosteroids.

High-dose steroid use ranged from 0.2 percent in young adults to 2.2 percent in people 75 years or older. Of those who used high doses of steroids, 72 percent used the drugs in pill form only, 15 percent used the drugs in the inhaled form only, and 13 percent used combined oral and inhaled steroids.

Just 27 percent of women and 9 percent of men who took steroid pills underwent bone density testing, the team found. Of those exposed to inhaled steroids, 23 percent of women and 4 percent of men underwent bone densitometry.

The team reports that 6 percent of men and 11 percent of women receiving oral steroids and 1 percent of men and 5 percent of women receiving inhaled steroids filled prescriptions for osteoporosis drugs.

The report authors remind readers of the importance of checking the bone health of individuals who regularly use high doses of steroids.

SOURCE: Annals of Allergy, Asthma, and Immunology, November 2006.