SynthesisDrug safety2008
Inhaled corticosteroids and the risk of fractures in older adults: a systematic review and meta-analysis.
Synthesis in Drug safety, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Risk of Fracture and Osteoporosis in Patients With COPD and Inhaled Corticosteroids Treatment.Respiratory care · 2023Pooled it
- Guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis: an update of Brazilian Society of Rheumatology (2020).Archives of osteoporosis · 2021Pooled it
- Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club.Frontiers in endocrinology · 2022Review
- Efficacy and Safety of Denosumab in Osteoporosis or Low Bone Mineral Density Postmenopausal Women.Frontiers in pharmacology · 2021Article
- Effects of long-term inhaled corticosteroid treatment on fragility fractures in older women: the Manitoba BMD registry study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- The risk of osteoporosis in patients with asthma.European clinical respiratory journal · 2020Review
- Long-Term Therapy with Corticosteroids in Nasal Polyposis: A Bone Metabolism Assessment.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2019Article
- An Official American Thoracic Society Workshop Report: Evaluation and Management of Asthma in the Elderly.Annals of the American Thoracic Society · 2016Article
- The Skeletal Effects of Inhaled Glucocorticoids.Current osteoporosis reports · 2016Review
- Glucocorticoid-induced osteoporosis: who to treat with what agent?Nature reviews. Rheumatology · 2015Review
- Interpretation and use of FRAX in clinical practice.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2011Review
- Low bone mineral density in men with chronic obstructive pulmonary disease.Respiratory research · 2011Article
- An overview of the benefits and drawbacks of inhaled corticosteroids in chronic obstructive pulmonary disease.International journal of chronic obstructive pulmonary disease · 2010Review
- Inhaled corticosteroids as combination therapy with beta-adrenergic agonists in airways disease: present and future.European journal of clinical pharmacology · 2009Review
- Falls in patients with chronic obstructive pulmonary disease: a call for further research.Respiratory medicine · 2009Review
- Asthma Over the Age of 65: All's Well That Ends Well.The journal of allergy and clinical immunology. In practiceReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInhaled corticosteroids (ICS) are commonly prescribed medications for the management of asthma and chronic obstructive pulmonary disease. It is well established that long-term use of these drugs may lower bone mineral density. However, whether ICS increase the risk of fractures remains unknown. Recent studies that have attempted to explore this risk have had conflicting results. We sought to explore the risk of ICS and fractures among older adults by conducting a systematic review and meta-analysis of the literature.
methodsWe systematically searched several databases, including MEDLINE, EMBASE and the Cochrane Library, to identify pertinent studies. Those studies that potentially met our inclusion criteria were identified by two reviewers. Relative risks (RRs) were pooled using the random effects model. We also explored dose-response by stratifying the analysis on high and low doses of ICS. Heterogeneity was assessed using the Q statistic and publication bias was assessed using the funnel plot.
resultsThirteen studies, including four randomized controlled trials, were included in the review. The pooled RRs for hip fractures and any fractures were 0.91 (95% CI 0.87, 0.96) and 1.02 (95% CI 0.96, 1.08), respectively. When we restricted the analysis to users of high-dose ICS, the pooled RRs for any fractures and hip fractures were 1.30 (95% CI 1.07, 1.58) and 1.32 (95% CI 0.90, 1.92), respectively. The funnel plot did not show evidence of publication bias.
conclusionWe found no association between the use of ICS and fractures in older adults. A slight increase in risk was seen in those using high-dose ICS. The significance of this association should be investigated further.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.