What can be a consequence of long-term, high-dose fluticasone therapy?

Long-term, high-dose therapy with fluticasone, which is an inhaled corticosteroid, can lead to decreased bone mineral density. Corticosteroids are known to have various effects on the body, one of which is the inhibition of bone formation. They reduce the proliferation and activity of osteoblasts, the cells responsible for forming new bone, while also increasing the rate of bone resorption, which is the process by which bone is broken down and minerals are released into the bloodstream. This imbalance can result in a net loss of bone density over time, increasing the risk of osteoporosis and fractures. Therefore, understanding the long-term impacts of fluticasone therapy is crucial, especially for populations such as children who are still growing and developing their skeletal structure.