People who use an inhaled steroid long-term to treat chronic obstructive pulmonary disease (COPD), or emphysema, face a loss of bone mineral density in the hip and spine, a new study shows.

The findings suggest the drugs should be prescribed with caution to COPD patients, Dr. Dr. John E. Connett, at the University of Minnesota, told AMN Health, especially because the study also found the medication did not improve lung function.

In the study, some 400 patients with COPD who were current smokers or had recently quit were randomly assigned to use inhaled triamcinolone twice daily or a placebo inhaler over a three-year period.

By the end of the study, patients on the drug showed an average decrease of 1.78 percent in bone density at the hip, and spine bone density fell 0.35 percent.

While this degree of bone loss would not be harmful in a person without bone thinning, the researchers write in the American Journal of Respiratory and Critical Care Medicine, it could pose a risk to people who already have some bone weakening - and longer-term use could also result in significant bone loss.

“It could be that before you prescribe a drug like this you would actually want to do a bone density test,” Connett said in an interview with Reuters Health.

He noted that triamcinolone, an older drug, is now less widely used than the inhaled steroids budesonide and fluticasone, and the effects of these drugs on bone mineral density are not clear.

SOURCE: American Journal of Respiratory and Critical Care Medicine, December 2004.