Severity of obstructive airway disease and risk of osteoporotic fracture
Severity of obstructive airway disease and risk of osteoporotic fracture
The use of inhaled corticosteroids has been associated with a dose-related increased risk of fracture. This may be related to systemic absorption. However, several studies have found that patients with more severe reductions in pulmonary function had reduced bone mineral density, independent of inhaled corticosteroids. The objective of this study was to evaluate the relationship between disease severity and fracture risk.
A large case–control study (108,754 cases) was conducted using data from the UK General Practice Research Database. It was found that higher doses of inhaled corticosteroids were associated with greater risks of fracture. The crude odds ratio of fracture among patients exposed to >1,600 µg beclomethasone equivalents per day was 1.95 (95% confidence interval (CI) 1.68–2.27). When adjustments were made for disease severity and use of bronchodilators, the initial dose–response relationship between inhaled corticosteroids and fracture risk disappeared (adjusted odds ratio of 1.19 (95% CI 1.01–1.41)).
In conclusion, patients with severe obstructive airway disease are at risk of fracture. However, adequate adjustment for disease severity is essential when the association between the use of inhaled corticosteroids and risk of osteoporotic fracture is studied in observational research.
anti-inflammatory agents, bronchodilator agents, hip fractures, obstructive lung diseases, spinal fractures
879-884
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
van Staa, T.P.
31b8bfb4-4e1b-4a48-a5a6-90ca601b94af
Bracke, M.S.G.M
67041845-8e36-42be-8f6e-e6820f678242
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Leufkens, H.G.M
e4e568af-4e47-4bd9-8701-91d27f1e9136
Lammers, J-W.J.
66117be1-77a2-4eb6-abd1-1bce818147e0
2005
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
van Staa, T.P.
31b8bfb4-4e1b-4a48-a5a6-90ca601b94af
Bracke, M.S.G.M
67041845-8e36-42be-8f6e-e6820f678242
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Leufkens, H.G.M
e4e568af-4e47-4bd9-8701-91d27f1e9136
Lammers, J-W.J.
66117be1-77a2-4eb6-abd1-1bce818147e0
de Vries, F., van Staa, T.P., Bracke, M.S.G.M, Cooper, C., Leufkens, H.G.M and Lammers, J-W.J.
(2005)
Severity of obstructive airway disease and risk of osteoporotic fracture.
European Respiratory Journal, 25 (5), .
Abstract
The use of inhaled corticosteroids has been associated with a dose-related increased risk of fracture. This may be related to systemic absorption. However, several studies have found that patients with more severe reductions in pulmonary function had reduced bone mineral density, independent of inhaled corticosteroids. The objective of this study was to evaluate the relationship between disease severity and fracture risk.
A large case–control study (108,754 cases) was conducted using data from the UK General Practice Research Database. It was found that higher doses of inhaled corticosteroids were associated with greater risks of fracture. The crude odds ratio of fracture among patients exposed to >1,600 µg beclomethasone equivalents per day was 1.95 (95% confidence interval (CI) 1.68–2.27). When adjustments were made for disease severity and use of bronchodilators, the initial dose–response relationship between inhaled corticosteroids and fracture risk disappeared (adjusted odds ratio of 1.19 (95% CI 1.01–1.41)).
In conclusion, patients with severe obstructive airway disease are at risk of fracture. However, adequate adjustment for disease severity is essential when the association between the use of inhaled corticosteroids and risk of osteoporotic fracture is studied in observational research.
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Published date: 2005
Keywords:
anti-inflammatory agents, bronchodilator agents, hip fractures, obstructive lung diseases, spinal fractures
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Local EPrints ID: 25397
URI: http://eprints.soton.ac.uk/id/eprint/25397
ISSN: 0903-1936
PURE UUID: 546e4225-7a86-47de-accf-fd5c7f021abe
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Date deposited: 07 Apr 2006
Last modified: 18 Mar 2024 02:44
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Contributors
Author:
F. de Vries
Author:
T.P. van Staa
Author:
M.S.G.M Bracke
Author:
H.G.M Leufkens
Author:
J-W.J. Lammers
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