The risk of osteoporosis in oral steroid treatment for nasal polyposis: A systematic review

Lisa Winblad*, Christian Grønhøj Larsen, Kåre Håkansson, Bo Abrahamsen, Christian von Buchwald

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Abstract

Background: Systemic glucocorticoids are often used in the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), and osteoporosis is a well-known complication to steroid treatment, associated with significant morbidity. Nevertheless, the burden of steroid induced osteoporosis is unknown in patients with CRSwNP. We aimed to assess the risk of acquiring osteoporosis caused by oral steroids in patients with CRSwNP, and provide recommendations on future research and guidelines. Methodology: Cochrane Review Database, EMBASE, Ovid Medline, and PubMed were searched for studies including adult patients with CRSwNP treated with oral steroids. Outcomes were Bone Mineral Density (BMD) and prevalence of fractures in relation to dose and duration of oral steroids. In addition, we reviewed general guidelines for treatment with oral steroids. Results: We identified two studies (n=243) that met the inclusion criteria. Doses and durations of oral steroids were >5 mg/day for ≥3 months and 1 mg/kg body weight/day for 6 to 10 days for ≥4 courses/year. The prevalence of low bone mass was 39% and 61%, respectively. It was not possible to quantify the overall risk of osteoporosis induced by oral steroids from the studies. No studies evaluated prevalence of fracture. Conclusions: Registry studies and randomized controlled trials would be needed to assess the risk of osteoporosis in CRSwNP patients and future guidelines should include recommendations regarding preventive treatment and recommendations on doses and durations of oral steroids.

OriginalsprogEngelsk
Sider (fra-til)195-201
Antal sider7
TidsskriftRhinology
Vol/bind55
Udgave nummer3
DOI
StatusUdgivet - 1 jan. 2017

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