help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Published ahead of print on January 7, 2004, doi:10.1164/rccm.200307-926OC
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Supplement
Right arrow All Versions of this Article:
200307-926OCv1
169/7/855    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lee, T. A.
Right arrow Articles by Weiss, K. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lee, T. A.
Right arrow Articles by Weiss, K. B.
American Journal of Respiratory and Critical Care Medicine Vol 169. pp. 855-859, (2004)
© 2004 American Thoracic Society

Original Article

Fracture Risk Associated with Inhaled Corticosteroid Use in Chronic Obstructive Pulmonary Disease

Todd A. Lee and Kevin B. Weiss

Midwest Center for Health Services and Policy Research, Hines VA Hospital, Hines; Center for Healthcare Studies, Division of General Internal Medicine, and the Department of Medicine, Feinberg School of Medicine, Northwestern University; and Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois

Correspondence and requests for reprints should be addressed to Todd A. Lee, Pharm.D., Ph.D., Midwest Center for Health Services and Policy Research, Hines VA Hospital, P.O. Box 5000 (151-H), Hines, IL 60141. E-mail: lee{at}research.hines.med.va.gov

Patients with chronic obstructive pulmonary disease (COPD) are frequently treated with inhaled corticosteroids (ICS). However, the impact of ICS use on fracture risk remains unclear in these patients. This nested case–control study examines the association between ICS use and nonvertebral fractures in Veterans Affairs patients with COPD. From a cohort of 40,157 patients with a COPD diagnosis between October 1, 1998 and September 30, 1999, and that used services in the preceding 12-month period but did not have a COPD diagnosis, 1,708 cases with nonvertebral fractures were identified and matched to 6,817 control patients. Patients were 94% male, and average age was 62.7 years. ICS exposure was identified through prescription records and converted to beclamethasone equivalents. In conditional logistic regression models, exposure to ICS at any time during follow-up was not associated with an increased fracture risk (adjusted odds ratio = 0.97; 95% confidence interval, 0.84–1.11). However, current high-dose ICS users (>= 700 µg per day) had an increased risk of fractures compared with patients with no exposure (adjusted odds ratio = 1.68; 95% confidence interval, 1.10–2.57). In patients with COPD, current use of high-dose ICS was associated with an increased risk of nonvertebral fractures.

Key Words: inhaled corticosteroids • pharmacoepidemiology • chronic obstructive pulmonary disease • nested case–control studies • fractures




This article has been cited by other articles:


Home page
 ChestHome page
T. Ohara, T. Hirai, S. Muro, A. Haruna, K. Terada, D. Kinose, S. Marumo, E. Ogawa, Y. Hoshino, A. Niimi, et al.
Relationship Between Pulmonary Emphysema and Osteoporosis Assessed by CT in Patients With COPD
Chest, December 1, 2008; 134(6): 1244 - 1249.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
W. M. Chatila, B. M. Thomashow, O. A. Minai, G. J. Criner, and B. J. Make
Comorbidities in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, May 1, 2008; 5(4): 549 - 555.
[Abstract] [Full Text] [PDF]

Home page
 Ther Adv Respir DisHome page
J. Tkac, S. F. P. Man, and D. D. Sin
Review: Systemic consequences of COPD
Therapeutic Advances in Respiratory Disease, October 1, 2007; 1(1): 47 - 59.
[Abstract] [PDF]

Home page
 Proc Am Thorac SocHome page
S. Suissa, R. McGhan, D. Niewoehner, and B. Make
Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, October 1, 2007; 4(7): 535 - 542.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
M. Pujades-Rodriguez, C.J.P. Smith, and R.B. Hubbard
Inhaled corticosteroids and the risk of fracture in chronic obstructive pulmonary disease
QJM, August 1, 2007; 100(8): 509 - 517.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. Hubbard, A. Tattersfield, C. Smith, J. West, L. Smeeth, and A. Fletcher
Use of inhaled corticosteroids and the risk of fracture.
Chest, October 1, 2006; 130(4): 1082 - 1088.
[Abstract] [Full Text] [PDF]

Home page
 Ann Fam MedHome page
G. Gartlehner, R. A. Hansen, S. S. Carson, and K. N. Lohr
Efficacy and Safety of Inhaled Corticosteroids in Patients With COPD: A Systematic Review and Meta-Analysis of Health Outcomes
Ann. Fam. Med, May 1, 2006; 4(3): 253 - 262.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. de Vries, T. P. van Staa, M. S. G. M. Bracke, C. Cooper, H. G. M. Leufkens, and J-W. J. Lammers
Severity of obstructive airway disease and risk of osteoporotic fracture
Eur. Respir. J., May 1, 2005; 25(5): 879 - 884.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. Fabbri, S. P. Peters, I. Pavord, S. E. Wenzel, S. C. Lazarus, W. MacNee, F. Lemaire, and E. Abraham
Allergic Rhinitis, Asthma, Airway Biology, and Chronic Obstructive Pulmonary Disease in AJRCCM in 2004
Am. J. Respir. Crit. Care Med., April 1, 2005; 171(7): 686 - 698.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. E. Bolton, A. A. Ionescu, K. M. Shiels, R. J. Pettit, P. H. Edwards, M. D. Stone, L. S. Nixon, W. D. Evans, T. L. Griffiths, and D. J. Shale
Associated Loss of Fat-free Mass and Bone Mineral Density in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., December 15, 2004; 170(12): 1286 - 1293.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. D. Scanlon, J. E. Connett, R. A. Wise, D. P. Tashkin, T. Madhok, M. Skeans, P. C. Carpenter, W. C. Bailey, A. S. Buist, M. Eichenhorn, et al.
Loss of Bone Density with Inhaled Triamcinolone in Lung Health Study II
Am. J. Respir. Crit. Care Med., December 15, 2004; 170(12): 1302 - 1309.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
A. E. Tattersfield, T. W. Harrison, R. B. Hubbard, and K. Mortimer
Safety of Inhaled Corticosteroids
Proceedings of the ATS, November 1, 2004; 1(3): 171 - 175.
[Abstract] [Full Text] [PDF]

Home page
 Evid. Based Nurs.Home page
23 Apr 2004 to 23 Jul 2004
Evid. Based Nurs., October 1, 2004; 7(4): e4 - e4.
[Full Text] [PDF]

Home page
 Evid. Based Med.Home page
Other articles noted
Evid. Based Med., September 1, 2004; 9(5): e5 - e5.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Suissa, P. Ernst, T. A. Lee, and K. B. Weiss
Inhaled Corticosteroids and Fracture Risk in COPD
Am. J. Respir. Crit. Care Med., July 1, 2004; 170(1): 94 - 95.
[Full Text] [PDF]

Home page
 JWatch GastroenterologyHome page
Inhaled Steroids, Bone Density, and Fractures
Journal Watch Gastroenterology, June 1, 2004; 2004(601): 9 - 9.
[Full Text]

Home page
 JWatch GeneralHome page
Inhaled Steroids, Bone Density, and Fractures
Journal Watch (General), April 27, 2004; 2004(427): 4 - 4.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2004 American Thoracic Society 		  CCM abstracts