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Lack of bone metabolism side effects after 3 years of nasal topical steroids in children with allergic rhinitis

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Abstract

This study evaluated the effects on bone mineral status of long-term treatment with intranasal budesonide (INB) spray, using the recommended dose, in pediatric patients with allergic rhinitis (AR). This retrospective, case–control study of 230 prepubertal children with perennial AR, who had used nasal budesonide at a mean daily dose of 100 μg (range, 89–132 μg) for at least 3 years intermittently, was conducted from May 2007 through May 2010. The bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry. Levels of serum calcium, phosphorus, alkaline phosphatase (ALP), parathyroid hormone, and osteocalcin were also assessed. The results were compared to sex- and age-matched controls (n = 140), who were newly diagnosed children with AR without any corticosteroid treatment. The 230 study patients (145 boys) were aged from 7 to 11 years. The average age (± SEM) was 8.7 ± 0.7 years; the mean (± SEM) steroid dosage used was 73.5 ± 7.0 μg daily, with 65.2 ± 5.2 g total steroid use during treatment. The 140 control patients (90 boys) were aged from 6 to 11 years. No significant differences were observed in BMD (P > 0.05) between the study and the control groups. Although mean serum ALP level was higher, and cortisol, phosphorus, and osteocalcin levels were lower, in the treatment group, these differences were not statistically significant. The findings suggest that long-term intermittent treatment for 3 years with INB spray, 50 μg twice daily, for children with perennial rhinitis revealed no negative effect on BMD and associated parameters.

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Acknowledgments

The authors have no financial or personal relationships with other persons or organizations that could pose a conflict of interest in connection with the present work.

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Authors and Affiliations

  1. Division Pediatric Allergy, Department of Pediatrics, Bezmialem Vakif University Medical Faculty, Fatih, Istanbul, Turkey

    Ozkaya Emin

  2. Department of Pediatrics, 70. Yıl Physical Therapy Center, Istanbul, Turkey

    Mete Fatih

  3. Doganhisar Government Hospital, Konya, Turkey

    Dibek Emre

  4. Department of Pediatrics, Suleymaniye Women and Child Hospital, Istanbul, Turkey

    Samanci Nedim

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  1. Ozkaya Emin
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  2. Mete Fatih
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Correspondence to Ozkaya Emin.

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Emin, O., Fatih, M., Emre, D. et al. Lack of bone metabolism side effects after 3 years of nasal topical steroids in children with allergic rhinitis. J Bone Miner Metab 29, 582–587 (2011). https://doi.org/10.1007/s00774-010-0255-3

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  • DOI: https://doi.org/10.1007/s00774-010-0255-3

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