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Elevated Fracture Risks in Patients Using Inhaled Corticosteroids: A Korean Nationwide Study
Sung Hye Kong1,2, Ae Jeong Jo3, Chan Mi Park4
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Inhaled corticosteroid (ICS) use in asthma patients, especially with osteopenia, significantly increases fracture risk. This highlights the need to monitor bone health in these individuals.
Area of Science:
- Gerontology
- Pharmacology
- Orthopedics
Background:
- Asthma management involves various medications with potential systemic effects.
- Bone health is a critical concern in aging populations.
Purpose of the Study:
- To investigate the association between different asthma medication classes and bone health outcomes.
- To evaluate the risk of osteoporotic and hip fractures in relation to asthma drug use.
Main Methods:
- Retrospective cohort study using South Korean National Health Insurance Service data (2015-2019).
- Included 6,173 66-year-old women with asthma, categorized by medication: nonusers, leukotriene antagonists, inhaled corticosteroids (ICS), and ICS+long-acting beta-agonist (LABA).
- Primary outcomes: incidence of major osteoporotic fractures and hip fractures.
Main Results:
- Over 2.7 years, 615 major osteoporotic and 96 hip fractures occurred.
- ICS and ICS+LABA users showed significantly higher risks for both fracture types (HRs > 1.38).
- The increased risk was particularly evident in patients with osteopenia.
Conclusions:
- Asthma medications, specifically ICS and ICS+LABA, are associated with increased fracture risk.
- Bone health monitoring is crucial for asthma patients, particularly older women and those with osteopenia.
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