Inhaled corticosteroids (ICS), used for the long-term treatment of asthma and chronic obstructive pulmonary disease (COPD), may be associated with systemic adverse effects such as a negative impact on bone health. Several large systematic analysis focused on this topic had reported conflicting results. We investigated the association between self-reported long-term ICS use (>12 months) and osteoporosis using data from the European Community Respiratory Health Survey (ECRHS) III (2010-2014). The Odds Ratio (OR) of osteoporosis in ICS versus non ICS users was computed adjusting for gender, age, smoking habits, BMI, oral steroids use by a 2-level random-intercept logistic model (centre: level 2 unit). Out of 5,107 subjects (aged 40-68, 52% female) with information on ICS use and osteoporosis, 463 (9%) were long-term ICS users; among them 89% reported ever-asthma and 23% (calculated considering only the 377 subjects who performed the bronchodilator challenge) had COPD. In the analysis adjusted only for centre, the risk of osteoporosis was significantly higher in ICS users than in non ICS users (OR=1.89, 95CI%:1.22, 2.85). When the analysis was adjusted for all the potential confounders the OR decreased to 1.34 (0.80, 2.24) without statistical significance (p=0.26). The risk of osteoporosis was higher in females (OR=8.5; 5.4, 13.5) and increased with age (OR=1.17; 1.13, 1.20 for one-year increase). Our results suggest the presence of an effect of ICS use on the risk of osteoporosis only in the analysis adjusted for centre, but these are preliminary data from a relatively young sample. Further analyses are needed, particularly taking into account different age groups and ICS treatment durations.
Use of inhaled corticosteroids and the risk of osteoporosis: an international cohort study
Cazzoletti, L;Zanolin, E;Corsico, AG;
2018-01-01
Abstract
Inhaled corticosteroids (ICS), used for the long-term treatment of asthma and chronic obstructive pulmonary disease (COPD), may be associated with systemic adverse effects such as a negative impact on bone health. Several large systematic analysis focused on this topic had reported conflicting results. We investigated the association between self-reported long-term ICS use (>12 months) and osteoporosis using data from the European Community Respiratory Health Survey (ECRHS) III (2010-2014). The Odds Ratio (OR) of osteoporosis in ICS versus non ICS users was computed adjusting for gender, age, smoking habits, BMI, oral steroids use by a 2-level random-intercept logistic model (centre: level 2 unit). Out of 5,107 subjects (aged 40-68, 52% female) with information on ICS use and osteoporosis, 463 (9%) were long-term ICS users; among them 89% reported ever-asthma and 23% (calculated considering only the 377 subjects who performed the bronchodilator challenge) had COPD. In the analysis adjusted only for centre, the risk of osteoporosis was significantly higher in ICS users than in non ICS users (OR=1.89, 95CI%:1.22, 2.85). When the analysis was adjusted for all the potential confounders the OR decreased to 1.34 (0.80, 2.24) without statistical significance (p=0.26). The risk of osteoporosis was higher in females (OR=8.5; 5.4, 13.5) and increased with age (OR=1.17; 1.13, 1.20 for one-year increase). Our results suggest the presence of an effect of ICS use on the risk of osteoporosis only in the analysis adjusted for centre, but these are preliminary data from a relatively young sample. Further analyses are needed, particularly taking into account different age groups and ICS treatment durations.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
