Oleg S Levin1, Anna G Polunina2, Marina A Demyanova3, Fedor V Isaev3. 1. Department of Neurology, Russian Medical Academy of Postgraduate Education, Botkinskiy proezd d.5, korp.19, Moscow 125101, Russia. 2. Principle Clinical Military Hospital, Federal Security Service of the Russian Federation, Golitzyno, Petrovskoe shosse d.48, Odinzovskiy r-n, Moscow Region 143040, Russia; Moscow Research and Practical Center of Narcology, Lyublinskaya ul. 37/1, Moscow 109390, Russia. Electronic address: anpolunina@mail.ru. 3. Principle Clinical Military Hospital, Federal Security Service of the Russian Federation, Golitzyno, Petrovskoe shosse d.48, Odinzovskiy r-n, Moscow Region 143040, Russia.
Abstract
BACKGROUND: Corticosteroid-induced myopathy is a well known clinical entity, and experimental studies showed decreased rate of protein synthesis and increased rate of protein breakdown in muscles of chronically treated animals. OBJECTIVE: The present observational study was aimed to evaluate skeletal muscle functions in asthmatics and patients with other chronic respiratory diseases treated by inhaled or oral corticosteroids. METHODS: Thirty six patients with respiratory diseases were included into the study. The physician-rated peripheral motor deficits scale, stepper test and ankle/wrist index were used for assessment of muscle functions. The effects of length of glucocorticoids intake on muscle functions were evaluated. RESULTS: Sixty five per cent of patients using corticosteroids daily during 1 year and longer reported weakness in legs, and 20% of these patients demonstrated objective signs of the muscle weakness. The performance on the stepper test was significantly worse in patients chronically using corticosteroids in comparison with the control group (10.9 ± 3.4 steps vs 16.1 ± 2.4 steps per 10s, respectively; F=21.6, p<0.001). In addition, a proportion of patients using corticosteroids for at least 18 months were characterized by muscle hypotrophy at a dominant leg. CONCLUSION: Chronic intake of inhaled corticosteroids induces clinically significant decrease of muscle functions at least after 1-year of daily treatment.
BACKGROUND: Corticosteroid-induced myopathy is a well known clinical entity, and experimental studies showed decreased rate of protein synthesis and increased rate of protein breakdown in muscles of chronically treated animals. OBJECTIVE: The present observational study was aimed to evaluate skeletal muscle functions in asthmatics and patients with other chronic respiratory diseases treated by inhaled or oral corticosteroids. METHODS: Thirty six patients with respiratory diseases were included into the study. The physician-rated peripheral motor deficits scale, stepper test and ankle/wrist index were used for assessment of muscle functions. The effects of length of glucocorticoids intake on muscle functions were evaluated. RESULTS: Sixty five per cent of patients using corticosteroids daily during 1 year and longer reported weakness in legs, and 20% of these patients demonstrated objective signs of the muscle weakness. The performance on the stepper test was significantly worse in patients chronically using corticosteroids in comparison with the control group (10.9 ± 3.4 steps vs 16.1 ± 2.4 steps per 10s, respectively; F=21.6, p<0.001). In addition, a proportion of patients using corticosteroids for at least 18 months were characterized by muscle hypotrophy at a dominant leg. CONCLUSION: Chronic intake of inhaled corticosteroids induces clinically significant decrease of muscle functions at least after 1-year of daily treatment.
Authors: Arno C Hessels; Johannes H van der Hoeven; Jan Stephan F Sanders; Elisabeth Brouwer; Abraham Rutgers; Coen A Stegeman Journal: PLoS One Date: 2019-02-04 Impact factor: 3.240