Pediatric Asthma Treatment Steroid Increases Fracture Risk Up to 3x
Nov 17, 2025
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Childhood asthma is a chronic inflammatory respiratory disease that requires lifelong management and is managed using inhaled steroids or systemic steroids. Inhalation steroids are a method of inhaling steroids with an inhaler or nebulizer, which acts locally only on the lungs to suppress inflammation and relieve respiratory symptoms. On the other hand, systemic steroids are limitedly used when acute exacerbation of asthma or asthma symptoms are not controlled, and affect the whole body with pills or injection treatment to regulate the immune response.
However, several studies have raised concerns that steroid use may negatively affect bone health, such as decreased bone density. Furthermore, it was not known in detail how it relates to fractures depending on the method and degree of steroid exposure (inhalation) or usage (whole body), and since children are active in bone formation and development, it was necessary to reveal the exact correlation between steroids used for treatment and fractures.
In response, Professor Kim Kyung-hoon conducted a study to precisely evaluate the impact of inhaled steroids and systemic steroid use on the risk of fractures in children with asthma.
The study used data from the National Health Insurance Service sample cohort and selected 2,324 children diagnosed with asthma after the age of 6 and 10,950 in the control group (non-asthmatic group) out of 30,000 children born between 2002 and 2004. The control group minimized bias by using propensity score matching method to correct gender, socioeconomic level, birth area, and comorbidities.
After that, each group was tracked from birth to 15 years old, and the period from the use of inhaled steroids to the fracture was classified as ▲91 to 180 days ▲ 181 to 365 days within ▲90 days, and systemic steroids were divided into ▲low dose (lower 25%) ▲ high dose (top 25%) by usage to evaluate the risk of fracture.
As a result of the study, the incidence of fractures within 90 days of inhaled steroids was about three times higher than that of the non-asthmatic group. In other periods, the risk of fracture was significantly higher. The systemic steroid use group was 2.15 times higher in the low dose and 3.09 times higher in the high dose, and the higher the dose, the higher the risk of fracture.
In addition, pediatric asthma patients have a 22% higher risk of fracture than non-asthmatic children, confirming that having childhood asthma alone can increase the risk of fracture.
This study clearly stated that steroid use to treat asthma can significantly increase the risk of fractures, and it is significant in that it compares and analyzes the incidence of fractures by period after inhalation steroids and the incidence of fractures according to the use of systemic steroids.
Professor Kim Kyung-hoon said, `As a result of research showing that steroid use increases the risk of fractures, unconditional avoidance of steroid use can worsen asthma"It is important for children suspected of asthma to choose a treatment through accurate treatment and examination by experts, and then to control the appropriate amount and duration of the drug with periodic evaluation" he said.
It is also important to monitor bone health while treating childhood asthma, and to maintain bone health by improving lifestyle such as regular exercise, sufficient sun exposure, and vitamin D supplementation.
Meanwhile, the study was published in Pediatric Allergy and Immunology, a prestigious international academic journal.
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This article was translated by Naver AI translator.
