No evidence inhaled corticosteroids increase osteoporosis risk

Osteoporosis is common in patients with COPD and concerns have been raised about the effect of long term use of inhaled corticosteroids on bone mineral density.

This study, published in Chest, investigated the effects of an inhaled corticosteroid (fluticasone), a long-acting beta-agonist (salmeterol) or the two in combination, on bone mineral density and bone fractures in patients with moderate-to-severe COPD over three years.

The researchers recorded the bone mineral density at the hip and lumbar spine at baseline and then yearly. The incidence of traumatic and non-traumatic bone fractures was recorded.

Only 43% of subjects completed the trial tests. At baseline, 18% of men and 30% of women had osteoporosis, and 42% of men and 41% of women had osteopenia. The changes in bone mineral density at the hip and lumbar spine over 3 years were small and no significant differences were observed between the active treatment groups and the placebo. The incidence of fractures was low and similar for all treatments.

The authors concluded that use of ICS has no significant effect on bone mineral density compared to a placebo in this trial.

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