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Inhaled corticosteroids and hip fracture: a population-based case-control study
Richard B Hubbard1, Chris J P Smith, Liam Smeeth
1Division of Respiratory Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, United Kingdom. richard.hubbard@nottingham.ac.uk
American Journal of Respiratory and Critical Care Medicine
|October 31, 2002
Summary
Inhaled corticosteroids are linked to an increased risk of hip fracture in older adults. This risk grows with higher doses, even after accounting for oral corticosteroid use.
Area of Science:
- Pharmacology
- Geriatric Medicine
- Epidemiology
Background:
- Inhaled corticosteroids (ICS) are linked to reduced bone mineral density.
- The association between ICS use and fracture risk remains unclear.
Purpose of the Study:
- To investigate the relationship between inhaled corticosteroid use and hip fracture risk.
- To determine if there is a dose-response relationship between ICS and hip fractures.
Main Methods:
- A case-control study using the General Practice Research Database.
- Included 16,341 hip fracture cases and 29,889 matched controls.
- Analyzed corticosteroid prescriptions and potential confounders using conditional logistic regression.
Main Results:
- Inhaled corticosteroid exposure was associated with an increased risk of hip fracture (OR 1.26).
- The risk remained significant after adjusting for oral corticosteroid use (OR 1.19).
- A dose-response relationship was observed between ICS use and hip fracture risk (p trend = 0.007).
Conclusions:
- Recent inhaled corticosteroid use is associated with a dose-related increase in hip fracture risk in older individuals.
- This finding highlights a potential safety concern for long-term ICS therapy in elderly populations.