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Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis.

Loke YK, Gilbert D, Thavarajah M, Blanco P, Wilson AM - BMJ Open (2015)

Bottom Line: Three RCTs and three observational studies in children reported on bone mineral density at the lumbar spine, and our meta-analysis did not show significant reductions with ICS use.Three RCTs and four observational studies in adults reported on ICS use and bone mineral density at the lumbar spine and femur, with no significant reductions found in the meta-analysis compared to control.ICS use for ≥12 months in adults or children with asthma was not significantly associated with harmful effects on fractures or bone mineral density.

View Article: PubMed Central - PubMed

Affiliation: Norwich Medical School, University of East Anglia, Norwich, UK.

No MeSH data available.


Related in: MedlinePlus

Fracture risk, ICS use versus non-use. ICS, inhaled corticosteroids.
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BMJOPEN2015008554F2: Fracture risk, ICS use versus non-use. ICS, inhaled corticosteroids.

Mentions: We identified one large long-term RCT in children that reported adjusted fracture rate of 5.7 per 100 patient years with budesonide as compared to 5.1 per 100 patient years with placebo (p=0.53).32 Similarly, there was no significant increase in likelihood of fracture in a meta-analysis of two observational studies in children, (OR 1.02, 95% CI 0.94 to 1.10, I2=0%)2729 as shown in figure 2. The point estimates of fracture risk was not significantly elevated at higher dose levels, with one study demonstrating an OR of 1.15 (0.89 to 1.48) for children with ≥20 prescriptions,27 and the other study reporting an OR of 1.17 (0.93 to 1.45) for children using a daily dose of >400 μg beclomethasone dipropionate equivalents.29


Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis.

Loke YK, Gilbert D, Thavarajah M, Blanco P, Wilson AM - BMJ Open (2015)

Fracture risk, ICS use versus non-use. ICS, inhaled corticosteroids.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663435&req=5

BMJOPEN2015008554F2: Fracture risk, ICS use versus non-use. ICS, inhaled corticosteroids.
Mentions: We identified one large long-term RCT in children that reported adjusted fracture rate of 5.7 per 100 patient years with budesonide as compared to 5.1 per 100 patient years with placebo (p=0.53).32 Similarly, there was no significant increase in likelihood of fracture in a meta-analysis of two observational studies in children, (OR 1.02, 95% CI 0.94 to 1.10, I2=0%)2729 as shown in figure 2. The point estimates of fracture risk was not significantly elevated at higher dose levels, with one study demonstrating an OR of 1.15 (0.89 to 1.48) for children with ≥20 prescriptions,27 and the other study reporting an OR of 1.17 (0.93 to 1.45) for children using a daily dose of >400 μg beclomethasone dipropionate equivalents.29

Bottom Line: Three RCTs and three observational studies in children reported on bone mineral density at the lumbar spine, and our meta-analysis did not show significant reductions with ICS use.Three RCTs and four observational studies in adults reported on ICS use and bone mineral density at the lumbar spine and femur, with no significant reductions found in the meta-analysis compared to control.ICS use for ≥12 months in adults or children with asthma was not significantly associated with harmful effects on fractures or bone mineral density.

View Article: PubMed Central - PubMed

Affiliation: Norwich Medical School, University of East Anglia, Norwich, UK.

No MeSH data available.


Related in: MedlinePlus