Loss of bone density with inhaled triamcinoline in lung health study II

Paul D. Scanlon, John E. Connett, Robert A. Wise, Donald P. Tashkin, Thelma Madhok, Melissa Skeans, Paul C. Carpenter, William C. Bailey, A (Sonia) Buist, Michael Eichenhorn, Richard E. Kanner, Gail Weinmann

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Inhaled glucocorticosteroids (ICS) are commonly prescribed for chronic obstructive pulmonary disease. No adverse effect on bone mineral density (BMD) has been proven. In a randomized double-blind, placebo-controlled trial at seven centers in North America, we recruited 412 current smokers or recent quitters with mild to moderate chronic obstructive pulmonary disease. They used inhaled triamcinolone acetonide, 600 mcg, or placebo, twice daily. We measured femoral neck and lumbar spine BMD at baseline and after 1 and 3 years, and serum osteocalcin at baseline, 3 months, 1 year, and 3 years. After 3 years, BMD at the femoral neck decreased 1.78% more with ICS than with placebo (p <0.001). More participants in the ICS group experienced 6% or more loss of femoral neck BMD (p = 0.002). Lumbar spine BMD increased in the placebo group by 0.98% but decreased by 0.35% in the ICS group (a difference of 1.33%, p = 0.007). Changes in osteocalcin did not correlate with changes in BMD. Fractures, lost height, or osteoporosis diagnoses were not increased among ICS users compared with placebo users. In summary, the use of inhaled triamcinolone acetonide was associated with loss of BMD at the femoral neck and lumbar spine after 3 years of treatment.

Original languageEnglish (US)
Pages (from-to)1302-1309
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume170
Issue number12
DOIs
StatePublished - Dec 15 2004
Externally publishedYes

Fingerprint

Bone Density
Femur Neck
Lung
Health
Placebos
Triamcinolone Acetonide
Spine
Osteocalcin
Chronic Obstructive Pulmonary Disease
North America
Osteoporosis
Serum

Keywords

  • Bone density
  • Obstructive lung diseases
  • Osteoporosis
  • Randomized controlled trials
  • Triamcinolone acetonide

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Scanlon, P. D., Connett, J. E., Wise, R. A., Tashkin, D. P., Madhok, T., Skeans, M., ... Weinmann, G. (2004). Loss of bone density with inhaled triamcinoline in lung health study II. American Journal of Respiratory and Critical Care Medicine, 170(12), 1302-1309. https://doi.org/10.1164/rccm.200310-1349OC

Loss of bone density with inhaled triamcinoline in lung health study II. / Scanlon, Paul D.; Connett, John E.; Wise, Robert A.; Tashkin, Donald P.; Madhok, Thelma; Skeans, Melissa; Carpenter, Paul C.; Bailey, William C.; Buist, A (Sonia); Eichenhorn, Michael; Kanner, Richard E.; Weinmann, Gail.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 170, No. 12, 15.12.2004, p. 1302-1309.

Research output: Contribution to journalArticle

Scanlon, PD, Connett, JE, Wise, RA, Tashkin, DP, Madhok, T, Skeans, M, Carpenter, PC, Bailey, WC, Buist, AS, Eichenhorn, M, Kanner, RE & Weinmann, G 2004, 'Loss of bone density with inhaled triamcinoline in lung health study II', American Journal of Respiratory and Critical Care Medicine, vol. 170, no. 12, pp. 1302-1309. https://doi.org/10.1164/rccm.200310-1349OC
Scanlon, Paul D. ; Connett, John E. ; Wise, Robert A. ; Tashkin, Donald P. ; Madhok, Thelma ; Skeans, Melissa ; Carpenter, Paul C. ; Bailey, William C. ; Buist, A (Sonia) ; Eichenhorn, Michael ; Kanner, Richard E. ; Weinmann, Gail. / Loss of bone density with inhaled triamcinoline in lung health study II. In: American Journal of Respiratory and Critical Care Medicine. 2004 ; Vol. 170, No. 12. pp. 1302-1309.
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