HealthDay News — Long-term, high-dose use of inhaled corticosteroids (ICSs) was associated with a modest increase in the risk for hip and upper extremity fractures in patients with chronic obstructive pulmonary disease (COPD), according to a study published in CHEST.

Anne V. Gonzalez, MD, from the McGill University Health Centre in Montreal, and colleagues used data from Quebec health care databases to identify a cohort of patients with COPD from 1990 to 2005 who were followed until 2007 for the first hip or upper extremity fracture. Each fracture case was matched with 20 controls by age, sex, and follow-up time as part of a nested case-control analysis.

The researchers found that 19,396 of 240,110 patients sustained a first hip or upper extremity fracture during a mean follow-up of 5.3 years (rate, 15.2 per 1000 per year). There was not an increased rate of fracture with any use of ICSs (adjusted rate ratio [aRR], 1.0; 95% CI, 0.97-1.03), although the fracture rate was increased with more than 4 years of ICS use at daily doses ≥1000 mg in fluticasone equivalents (aRR, 1.1; 95% CI, 1.02-1.19). There were no differences in this risk increase between men and women.

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“Long-term ICS use at high doses is associated with a modest increase in the risk of hip and upper extremity fractures in patients with COPD,” the authors wrote.

Disclosures: One author disclosed financial ties to pharmaceutical companies, including Novartis, which provided funding for the study.

Reference

Gonzalez AV, Coulombe J, Ernst P, Suissa S. Long-term use of inhaled corticosteroids in COPD and the risk of fracture. CHEST. 2018;153(2):321-328.