For patients with asthma, oral corticosteroid (OCS) and inhaled corticosteroid (ICS) use is associated with an increased risk for osteoporosis and fragility fractures (FFs), according to a study published online Oct. 20 in Thorax. Christos V. Chalitsios, from the University of Nottingham in the United Kingdom, and colleagues conducted two nested case-control studies to examine the risk for osteoporosis and FF due to corticosteroid use in asthma. Patients with osteoporosis or FF and gender-, age-, and practice-matched controls were identified using an asthma cohort. The researchers observed a dose-response relationship between both cumulative dose and number of OCS/ICS prescriptions within the previous year with osteoporosis or FF risk. People receiving more OCS prescriptions (≥9 versus 0) had a 4.50 and 2.16 increased risk for osteoporosis and FF, respectively, after adjustment for confounders. The odds ratios were 1.60 and 1.31 for osteoporosis and FF, respectively, for ICS (≥11 versus 0). A similar impact was seen for the cumulative dose, with greater risk for those receiving more OCS or ICS. For osteoporosis and FF, the prevalence of patients taking ≥9 OCS and at least one bisphosphonate prescription was 50.6 and 48.4 percent, respectively. “The use of OCS and ICS should be kept to the minimum necessary to treat symptoms and should be stepped down if symptoms and exacerbations are well managed,” the authors write. Source
