Review: Long-term use of inhaled corticosteroids increases fracture risk in COPD

摘要

In patients with chronic obstructive pulmonary disease (COPD), is long-term use of inhaled corticosteroids (ICSs) associated with increased risk for fractures? Review scope Included studies were randomized controlled trials (RCTs) that compared fiuticasone (FLU) or budesonide (BUD) with control, or an ICS and a long-acting beta_2-agonist (LABA) with LABA alone, in patients with COPD, and reported fractures. Observational studies that compared any ICS exposure with no ICS exposure in patients with COPD and reported odds ratios or data that enabled calculation of odds ratios for fractures were also included. Studies that assessed ICS use in acute exacerbations of COPD, those that included patients with other diseases but did not separately report outcomes for patients with COPD, and those with follow-up < 24 weeks were excluded.