Use of oral corticosteroids and risk of fractures.

摘要: Treatment with systemic corticosteroids is known to increase the risk of fractures but little fracture risks associated inhaled corticosteroids. A retrospective cohort study was conducted using a large UK primary care database (the General Practice Research Database [GPRD]). Inhaled corticosteroid users aged 18 years or older were compared matched control patients and group noncorticosteroid bronchodilator users. Patients concomitant use excluded. The comprised 170,818 users, 108,786 patients. average age 45.1 in corticosteroid, 49.3 bronchodilator, 45.2 groups. In cohort, 54.5% female. relative rates (RRs) nonvertebral, hip, vertebral during treatment 1.15 (95% CI, 1.10-1.20), 1.22 1.04-1.43), 1.51 1.22-1.85), respectively. No differences found between groups (nonvertebral RR = 1.00; 95% 0.94-1.06). nonvertebral among budesonide (RR 0.95; 0.85-1.07) fluticasone propionate 1.03; 0.71-1.49) similar rate determined for beclomethasone dipropionate. We conclude that have an increased fracture, particularly at hip spine. However, this excess may be related more underlying respiratory disease than corticosteroid.