21 Oct Oral and Inhaled Corticosteroids For Asthma Linked to Increased Risk of Osteoporosis
MedicalResearch.com Interview with:
Christos Chalitsios B.Sc, M.Sc PhD student
Funded by British Medical Association (BMA)
School of Medicine
Division of Respiratory Medicine
University of Nottingham
MedicalResearch.com: What is the background for this study?
Response: Inhaled (ICS) and oral (OCS) corticosteroids play a crucial role in the control of airway inflammation in asthma. Given that the use of ICS in asthma is likely to increase with the recent change in GINA guidance recommending combined long-acting-β2-agonists with ICS at step 1 and the upward trend in prescribing of OCS, we sought to clarify the link between steroids, osteoporosis and FF in patients with asthma, stratifying the risk by dose, number of courses and type of steroids. The prevalence of patients receiving at least one bisphosphonate was also calculated.
MedicalResearch.com: What are the main findings?
Response: Analysis of all the data showed a clear association between both cumulative dose and number of courses of inhaled or steroid tablets and the risk of osteoporosis or fragility fractures. Only around half of patients prescribed steroid tablets and even fewer prescribed steroid inhalers were prescribed bisphosphonates in the year leading up to a diagnosis of osteoporosis or fragility fracture.
MedicalResearch.com: What should readers take away from your report?
Response: Exposure to OCS or ICS is an independent risk factor for bone health in patients with asthma. There is a clear dose–response relationship between cumulative dose and prescriptions of OCS/ICS, and risk of osteoporosis and fragility fractures. Steroid administration at the lowest possible level to maintain asthma control is recommended. Bisphosphonate comedication should be considered according to guidelines for bone protection.
Any disclosures? We are grateful to the British Medical Association (BMA), whose funding made this research work possible.
Chalitsios CV, Shaw DE, McKeever TM. Thorax Epub ahead of print: [please include Day Month Year]. doi:10.1136/ thoraxjnl-2020-215664
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