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Therapeutics
Systematic review and meta analysis
Inhaled corticosteroids for people with chronic obstructive pulmonary disease are associated with an increased risk of fracture
  1. Nirupama Putcha,
  2. M Bradley Drummond
  1. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to M Bradley Drummond
    Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, JHAAC 4B.70 Baltimore, MD 21224, USA; mdrummo3{at}jhmi.edu
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http://dx.doi.org/10.1136/ebm.2011.100221

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    Commentary on: Loke YK, Cavallazzi R, Singh S. Risk of fractures with inhaled corticosteroids in COPD: systematic review and meta-analysis of randomised controlled trials and observational studies. Thorax 2011;66:699–708.OpenUrlAbstract/FREE Full Text

    Context

    Inhaled corticosteroids (ICS) are recommended for the management of moderate to severe chronic obstructive pulmonary disease (COPD).1 2 Previous investigations on the adverse effects of ICS on bone health in individuals with COPD have yielded conflicting results. Some trials3 have found that ICS can worsen bone mineral density (BMD) but not fracture risk, whereas other studies4 5 have found no such effect. Meta-analyses have also yielded contradictory findings.6 7 Understanding the strength and characteristics of this association is important as fractures can have serious …

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