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Widely Used COPD Meds Tied to Higher Fracture Risk

By Robert Preidt

HealthDay Reporter

TUESDAY, Feb. 13, 2018 (HealthDay News) — Many sufferers with power obstructive pulmonary illness (COPD) are put on tough inhaled corticosteroid remedy to ease signs.

But new analysis suggests the remedy would possibly lift their odds for bone fractures.

Still, the Canadian find out about wasn’t in a position to turn out cause-and-effect, and the entire possibility remained small, stated one knowledgeable no longer hooked up to the find out about.

“Looking at their data, there would be an estimated 1 [extra] fracture for every 241 patients using high-dose inhaled corticosteroids for over four years,” stated Dr. Walter Chua. He’s the senior attending doctor for pulmonary care at Northwell Health’s Long Island Jewish Forest Hills health facility in Forest Hills, N.Y.

Chua believes that even though steroids would possibly lift bone fracture possibility, “patients should not panic as the risk of fracture is small and we have ways of monitoring that risk.”

COPD — regularly related to smoking — is a mixture of emphysema and persistent bronchitis. It is a innovative, debilitating sickness that these days has no treatment. COPD stays the quantity 3 killer of Americans.

Many COPD sufferers are given inhaled corticosteroid drugs to lend a hand alleviate signs. But, in accordance to the find out about crew, prior analysis has urged that the medicine would possibly scale back bone mineral density, specifically in postmenopausal girls.

The new find out about used to be led by means of Dr. Samy Suissa of McGill University in Montreal. His crew tracked results for greater than 240,000 COPD sufferers, elderly 55 and older, within the Canadian province of Quebec.

During a median follow-up of simply over 5 years, the entire fracture price used to be simply over 15 folks in keeping with 1,000 sufferers in keeping with 12 months.

However, the speed used to be upper amongst sufferers who had used inhaled corticosteroids for longer than 4 years, at day-to-day doses of one,000 micrograms or extra.

Gender did not appear to play a task, because the possibility rose similarly for women and men, Suissa’s crew stated.

The find out about seems within the February factor of the magazine Chest.

“Since fractures are more frequent in women than men, our study suggests that the excess number of fractures associated with [inhaled corticosteroids] will be greater in women — even though we did not find that the risk increase was particularly higher in women than in men,” Suissa stated in a magazine information liberate.


So what does this imply for the various COPD sufferers who’re the use of corticosteroids?

Dr. Ann Tilley is a pulmonologist at Lenox Hill Hospital, in New York City. She wasn’t concerned within the new analysis, however learn over the findings and wired that it could not turn out cause-and-effect.

Information on different affected person elements that would possibly lift bone fracture — such things as smoking standing, weight problems and workout ranges — were not accounted for, Tilley famous.

Still, “the most important take-home message here is that long-term use of high-dose inhaled steroids may not be without risk,” Tilley stated, “and we should try to minimize their use when possible.”

“I would encourage patients to talk to their doctors about their inhalers and ask specifically if they need to be using an inhaled corticosteroid, and if so, could a lower dose be tried,” she stated.

Chua agreed, noting that different analysis has additionally proven “a slight uptick in the rates of pneumonia [for COPD patients] while on inhaled corticosteroids.”

He believes that for sufferers with showed COPD, “inhalers containing corticosteroids should generally be reserved as a last line of treatment after optimization of other inhaler alternatives.”

And if sufferers will have to use steroids, they “should be monitored for bone mineral density and fracture risk, for which we have medications/therapies to help reduce that risk,” Chua stated.

WebMD News from HealthDay


SOURCES: Walter Chua, MD , senior pulmonary attending doctor, Northwell Health’s Long Island Jewish Forest Hills, Forest Hills, NY; Ann Tilley, MD, pulmonologist, Lenox Hill Hospital, New York City;Chest, information liberate, Feb. five, 2018

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