ICS and Nonvertebral Fracture Rate

The results of a study, reported in Chest (January 2005), showed that the risk of nonvertebral fracture, in the short term, is not increased in older adults with chronic obstructive pulmonary disease (COPD) or asthma who use inhaled corticosteroids (ICS). For the study, the researchers analyzed the possibility of nonvertebral fracture in 89,877 adults who had submitted insurance claims for asthma and/or COPD.

Overall, 1722 patients were treated for a nonvertebral fracture. The researchers used the insurance claim of the first fracture as the index date. A total of 17,220 controls were randomly chosen and assigned a random index date. The investigators tracked ICS exposure at 1 month, 3 months, 6 months, and 1 year before the index date. Estimated cumulative doses at different time periods were determined. The findings showed that ~35% of the study population was exposed to ICS. Specifically, 15% were exposed to fluticasone propionate, 22% were exposed to other ICS, and 27% had exposure to oral corticosteroids in the year prior to the index date.