Asthma treatments linked to bone health

Some asthma treatments may be linked to a raised risk of osteoporosis and fracture, researchers warn today.

Both inhaled and oral corticosteroids are often prescribed for asthma, to help control inflammation in the airways. However, they are known to cause side effects including osteoporosis which can lead to bone fractures.

Previous studies have shown contradictory findings, so a team from the University of Nottingham, UK, set out to clarify the link.

Professor Dominick Shaw and his team carried out two studies using information from UK medical databases.

Their analysis showed a dose-response relationship between inhaled and oral corticosteroid prescriptions and risk of osteoporosis or fractures caused by fragility.

People receiving more oral corticosteroid prescriptions had a 4.5 and 2.2 times increased risk of osteoporosis and fragility fracture respectively, they report. For inhaled corticosteroids, the risks were 1.6 and 1.3, respectively.

They write: “The findings suggest that exposure to inhaled and oral corticosteroids is an independent risk factor for bone health in patients with asthma. Steroid administration at the lowest possible level to maintain asthma control is recommended.”

The research is published today (21 October) in BMJ Thorax . The team adds: “Current guidelines on asthma do not fully cover the management of bone comorbidities and no specific bone protection guidance is given. Our results suggest that risk and prevention of osteoporosis and fragility fractures should be addressed explicitly in future guideline updates.”

Chalitsios, C. V. et al. Risk of osteoporosis and fragility fractures in asthma due to oral and inhaled corticosteroids: two population-based nested case-control studies. Thorax 20 October 2020 doi: 10.1136/thoraxjnl-2020-215664

https://thorax.bmj.com/lookup/doi/10.1136/thoraxjnl-2020-215664

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