Review: inhaled corticosteroids for asthma or chronic obstructive pulmonary disease do not increase bone loss.

Main results 7 studies met the selection criteria. 4 studies recruited patients with mild asthma or COPD (1870 patients, 67% men), and 3 studies recruited healthy volunteers (119 people, 66% women). Duration of follow up ranged from 6 weeks to 3 years. Inhaled corticosteroids used were beclomethasone, budesonide, and fluticasone. Inhaled corticosteroids at all doses did not differ from placebo for vertebral fractures (2 studies); change in BMD (3 studies); or concentrations of osteocalcin (3 studies), C-terminal propeptide of type-one pro collagen (1 study), parathyroid hormone (1 study), alkaline phosphatase (1 study), or urinary hydroxyproline (1 study) (table). Conclusion In patients with asthma or chronic obstructive pulmonary disease, inhaled corticosteroids do not increase vertebral fractures, reduce bone mineral density, or change biochemical markers.