Inhaled Corticosteroids Accelerate Bone Density Loss in Women With Asthma, COPD

Older women with asthma or chronic obstructive pulmonary disease (COPD) who have used a long-term inhaled corticosteroid (ICS) have greater bone mineral density (BMD) loss in the hip compared with those who have not used an ICS, according to a new study.

The researchers identified 6561 women aged older than 40 years who had asthma or COPD and were registered in a population-based bone densitometry registry linked with administrative health data from residents of Manitoba, Canada, from 1999 and 2013.

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To measure ICS exposure, the researchers reviewed the cumulative dispensed days and medication possession ratio. Participants were considered to have had a high exposure if they had used ICS for 720 days or longer.

At baseline, the participants who had high exposure of ICS had lower BMD at the femoral neck and total hip. However, the lumbar spine was not affected.

After a mean 5-year follow-up, the researchers found that the participants who had used an ICS at the highest exposure had a −0.02 SD/year greater decline in total hip BMD, compared with those who did not use an ICS.

There was no significant effect at the femoral neck or lumbar spine.

—Colleen Murphy

Reference:

Chen, W, Johnson KM, FitzGerald JM, Sadatsafavi M, Leslie WD. Long-term effects of inhaled corticosteroids on bone mineral density in older women with asthma or COPD: a registry-based cohort study [published online October 29, 2018]. Arch Osteoporos. https://doi.org/10.1007/s11657-018-0537-2.