Long-term inhaled corticosteroid use not linked to fracture risk in asthma

Review offers reassurance over link between long-term use of inhaled corticosteroids and bone density.

Inhaled corticosteroids (ICS) are a recommended first-line preventative therapy for asthma and long-term use is not linked with bone-density-related adverse effects, such as osteoporosis and fractures. In the image, a woman holds an asthma inhaler

Inhaled corticosteroids (ICS) are a recommended first-line preventive therapy for asthma. However, some studies have linked long-term use with bone density-related adverse effects, such as osteoporosis and fractures, but most of these studies have included patients with chronic obstructive pulmonary disease who may be more susceptible to these outcomes. 

A systematic review, published in BMJ Open (online, 24 November 2015)[1]
, has found no association between ICS use lasting one to four years and these adverse events. Among 18 observational and randomised controlled studies involving only patients with asthma, the researchers found no link between ICS and the risk of fractures in children or adults, nor with bone mineral density loss. 

Researchers say the findings should provide reassurance to prescribers, and help them more accurately judge the benefits and harms of ICS treatment for asthma.

References

[1] Loke YK, Gilbert D, Thavarajah M et al. Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis. BMJ Open 2015;5:e008554. doi:10.1136/bmjopen-2015-008554

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Citation
Clinical Pharmacist, CP, January 2016, Vol 8, No 1;8(1):DOI:10.1211/PJ.2015.20200199