Glucocorticoids in the treatment of acute pediatric asthma rehabilitated

Glucocorticoids are not a risk factor for osteopenia and, therefore, do not increase the risk of fractures, conclude the authors of a study, thereby exonerated the treatment of pediatric asthma.

Many parents of children with acute asthma, but many doctors, show a reluctance or a strong resistance to the repeated use of glucocorticoids orally because of the potential side effects of these steroids.

A Quebec team from McGill University (Montreal) has conducted a study to assess the safety of short courses (5 days) but repeated oral glucocorticoids on bone mineralization, metabolism and adrenal function.

The researchers examined 83 children, aged 2-17 years, 48 of whom had received the emergency treatment at least twice a year and that the doctors had prescribed glucocorticoids in case of an asthma attack.

Among children exposed to drugs evaluated, a reduction in serum osteocalcin was observed at the end of 5 days of treatment, with a return to normal after 30 days, the authors note in the journal "Annals of Emergency Medicine ".

Moreover, the average score of bone density was similar in the two groups of children. No cases of abnormal response to adrenocorticotropin, suggesting adrenal insufficiency was observed in treated children, nor in others.

These results support the notion that glucocorticoids are not a risk factor for osteopenia, and a fortiori of fractures, the authors conclude.

These, however, have noted that younger patients had bone mineral density slightly lower before treatment, but the reasons are not known. Is this due to diet, lack of exercise, idiopathic, do they ask?

In addition, doses of corticosteroids administered to patients was relatively small. What higher doses, as used by pediatricians specialized in immunology and allergy? These issues are studied, the researchers said, and pending the results, they want to reassure parents about the safety of a short treatment with glucocorticoids, which they say will certainly more beneficial to their child no treatment.