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Minerva Medica 2021 Jun 11

DOI: 10.23736/S0026-4806.21.07431-0


language: English

Inhaled corticosteroids and risk of osteoporosis in late-middle age subjects: a multicenter European cohort study

Amelia GROSSO 1 , Isa CERVERI 1, Lucia CAZZOLETTI 2, Maria E. ZANOLIN 2, Veronica MATTIOLI 2, Davide PILONI 1, Erica GINI 1, Federica ALBICINI 1, Vanessa RONZONI 1, Debbie JARVIS 3, Christer JANSON 4, Angelo G. CORSICO 1

1 Division of Respiratory Diseases, Department of Internal Medicine and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy; 2 Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy; 3 Department of Population Health and Occupational Diseases, National Heart and Lung Institute, Imperial College London, London, UK; 4 Department of Medical Sciences, Respiratory, Allergy & Sleep Research, Uppsala University, Uppsala, Sweden


BACKGROUND: Inhaled corticosteroids have been widely used for the regular treatment of asthma and COPD over the past few decades. To date, studies investigating the effects of ICS on bone in populations including asthma and COPD patients, show conflicting results. The skeletal effects of ICS remain poorly understood. We assessed the association between ICS exposure and self-reported osteoporosis diagnosis in a European cohort study.
METHODS: The analysis was carried out by using clinical and questionnaire data available for subjects participating in the ECRHS III (European Community Respiratory Health Survey) with age >55 years.
RESULTS: Among the 3004 enrolled subjects, 245 were ICS users with an exposure ≥12 months. Osteoporosis was reported by 16 subjects in the ICS group (6.5%) and by 167 in the not exposed group (6.1%). The adjusted risk of osteoporosis in ICS users (≥12 months) was not greater in exposed subjects when compared with the unexposed ones (OR=1.02, 95CI%: 0.51, 2.03). The same result was observed even when considering in the analysis a longer exposure to the ICS use (≥ 36.5 months, the median ICS exposure for all subjects). History of COPD, use of oral corticosteroids, Body Mass Index, smoking and physical activity did not show any evidence of an association with osteoporosis.
CONCLUSIONS: Our study did not show any significant association between long- term ICS use and self-reported diagnosis of osteoporosis in subjects aged >55 years. To explore the real effect of ICS on bone status, further studies are needed, especially in the long-term ICS exposure.

KEY WORDS: Inhaled corticosteroids; Osteoporosis; Asthma; COPD

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