Inhaler use doesn't usually up risk of fractures

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Inhaler use doesn't usually up risk of fractures

Last Updated: 2004-01-16 12:00:23 -0400 (Reuters Health)

NEW YORK (Reuters Health) - People who have to take oral steroid

medications for long periods are known to be prone to break bones.

However, new research shows that older patients with respiratory

conditions who use inhaled or nasal-spray steroids at the usual

recommended dose do not have an increased risk for fractures.

At higher doses, though, there is an increased risk of broken arms.

Dr. Samy Suissa, of Royal Hospital, Montreal, Canada, and

colleagues studied all Quebec patients at least 65 years of age who were

dispensed respiratory medications and followed for at least 4 years. For

comparison purposes, these patients were matched to a group of similar

age.

As they report in the American Journal of Respiratory and Critical Care

Medicine, the researchers identified 3326 new hip fractures and 6298 arm

fractures that occurred during follow-up. The average age of the

subjects was 81 years.

Overall, there was no difference in fracture rates between those who

used inhaled/nasal steroids and those who did not.

The rate of arm fractures, but not hip fractures, did increase by 12

percent with every 1000-microgram increase in the daily dose of inhaled

corticosteroids.

Among subjects who were followed for over 8 years, " only the use of more

than 2000 micrograms of inhaled corticosteroids per day for an average

of 6 years was associated with an elevated risk of fracture, " Suissa and

colleagues write.

The rate was not increased at any dose of nasal corticosteroids.

" The implications of our results for the treatment of respiratory

disease are important, " the researchers conclude. " The fact that

long-term use of inhaled corticosteroids does not appear to be

associated with an increased risk of hip or upper extremity fracture,

except at very high doses, suggests that the doses corresponding to the

current treatment guidelines are safe. "

SOURCE: American Journal of Respiratory and Critical Care Medicine,

January 1, 2004.