Parents concerned about use of oral steroids to treat their asthmatic children will be reassured by a new study conducted by a team of clinicians at the Research Institute of the McGill University Health Centre (MUHC) and the Shriners Hospital (Montreal). This study, the first to evaluate the effects of short courses of oral steroids on bone density and hormone function, was published in the February issue of the international journal Pediatrics.
"Often parents will be hesitant to administer prescribed oral glucocorticoids, a subset of steroids, to their asthmatic children because they are worried about the potential side effects," says Dr. Francine Ducharme, pediatrician at the Montreal Children's Hospital of the MUHC and lead author of the study. "These drugs are extremely effective at reducing inflammation of the airways and treating asthma flare-ups. This study shows that parents do not need to be concerned when these drugs are used for up to five days to treat acute asthma exacerbations."
"One of the main concerns with glucocorticoid use is their effect on bones," says Dr. Gilles Chabot, pediatrician at the Shriners Hospital and coauthor of the study. "We were able to look directly at the children's bones and determine that the repeated short courses of oral glucocorticoids had no detectable cumulative negative effect on bone formation."
The study compared the density of bones and the functioning of the adrenal gland, an organ that secretes natural steroids, of asthmatic children who received repeated short courses of oral glucocorticoids with those who were not prescribed the drugs. In total, 83 children were evaluated, some receiving as many as 11 short treatments in the course of 1 year. The findings showed that the glucocorticoids do not have lasting negative effects on bone metabolism and bone density, or on the functioning of the adrenal gland. In addition, there was no impact of the drugs on the children's weight or height.
"Although this study does not address the effect of long term use of glucocorticoids, we hope that it may alleviate some concerns about the safety of using these very effective drugs over the short term," says Dr. Ducharme.
"This is the first study to look at both hormonal function and bone health following exposure to glucocorticoids. This would not have been possible without the collaborative efforts between our institutions," she concluded.
This study was supported by a grant from the National Health Research and Development Program of Canada.