SynthesisBMJ open2015
Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis.
Synthesis in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 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
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- A systematic review of adverse drug events associated with administration of common asthma medications in children.PloS one · 2017Pooled it
- Long-Term Selenium-Yeast Supplementation Does Not Affect Bone Turnover Markers: A Randomized Placebo-Controlled Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Trial
- Fluticasone Propionate/Anti-IgE Combination Preserves Bone Mechanical and Mineral Integrity Better than Monotherapies or Anti-TNF-α in Mice with Ovalbumin-Induced Allergic Airway Inflammation.International journal of molecular sciences · 2026Article
- Inhaled Corticosteroid/Long-Acting βAdvances in therapy · 2026Review
- Bone health in asthma: a twofold effect of disease and pharmacotherapy.Frontiers in endocrinology · 2026Review
- Long-term intranasal corticosteroids vs. antihistamines and bone health in post-menopausal women with allergic rhinitis: a retrospective cohort study.Frontiers in medicine · 2026Article
- Vitamin D Supplementation and Its Interaction with Common Medications: Impact on Serum Levels and Quality of Life in Adults with Comorbidities.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Evaluation of vitamin D deficiency and low bone mass in children with asthma in fars province: A case-control study.Health science reports · 2024Article
- Association of Different Prescribing Patterns for Oral Corticosteroids With Fracture Preventive Care Among Older Adults in the UK and Ontario.JAMA dermatology · 2023Article
- Novel multimorbidity clusters in people with eczema and asthma: a population-based cluster analysis.Scientific reports · 2022Article
- Article
- Mild asthma in adults and adolescents: Inhalers, adherence, and optimization.Canadian family physician Medecin de famille canadien · 2022Article
- Prevention and Treatment of Glucocorticoid-Induced Osteoporosis in Adults: Consensus Recommendations From the Belgian Bone Club.Frontiers in endocrinology · 2022Review
- Oxidative Stress Promotes Corticosteroid Insensitivity in Asthma and COPD.Antioxidants (Basel, Switzerland) · 2021Review
- A Literature Review of the Potential Impact of Medication on Vitamin D Status.Risk management and healthcare policy · 2021Review
- Bone mineral density, osteopenia, osteoporosis, and fracture risk in patients with atopic dermatitis: a systematic review and meta-analysis.Annals of translational medicine · 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
- Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update.Pharmaceutics · 2018Review
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 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe aimed to assess the association between long-term use of inhaled corticosteroids (ICS) and bone adverse effects in patients with asthma.
designSystematic review and meta-analysis of fracture risk and changes in bone mineral density with long-term ICS use in asthma.
methodsWe initially searched MEDLINE and EMBASE in July 2013, and performed an updated PubMed search in December 2014. We selected randomised controlled trials (RCTs) and controlled observational studies of any ICS (duration at least 12 months) compared to non-ICS use in patients with asthma. We conducted meta-analysis of ORs for fractures, and mean differences in bone mineral density. Heterogeneity was assessed using the I(2) statistic.
resultsWe included 18 studies (7 RCTs and 11 observational studies) in the systematic review. Meta-analysis of observational studies did not demonstrate any significant association between ICS and fractures in children (pooled OR 1.02, 95% CI 0.94 to 1.10, two studies), or adults (pooled OR 1.09, 95% CI 0.45 to 2.62, four studies). Three RCTs and three observational studies in children reported on bone mineral density at the lumbar spine, and our meta-analysis did not show significant reductions with ICS use. Three RCTs and four observational studies in adults reported on ICS use and bone mineral density at the lumbar spine and femur, with no significant reductions found in the meta-analysis compared to control.
conclusionsICS use for ≥12 months in adults or children with asthma was not significantly associated with harmful effects on fractures or bone mineral density.
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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.