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Meta-Analysis
. 2008 Sep;38(9):1451-8.
doi: 10.1111/j.1365-2222.2008.03029.x. Epub 2008 Jun 3.

Dose-response relationship for risk of non-vertebral fracture with inhaled corticosteroids

M Weatherall  1 , K James, J Clay, K Perrin, M Masoli, M Wijesinghe, R Beasley
Affiliations
Meta-Analysis

Dose-response relationship for risk of non-vertebral fracture with inhaled corticosteroids

M Weatherall et al. Clin Exp Allergy. 2008 Sep.

Abstract

Objective: To determine the strength of association between the dose of inhaled corticosteroids (ICS) and risk of non-vertebral fracture in adults.

Methods: A systematic review and meta-analysis of case-control studies of non-vertebral fractures in adults, in which at least two doses of ICS were reported as the dose of beclomethasone dipropionate (BDP) or equivalent.

Results: Five case-control studies were identified, with a total of 43 783 cases and 259 936 controls. There was an association between the risk of non-vertebral fracture and increasing dose of BDP. The random-effects odds ratio of relative risk for a non-vertebral fracture was 1.12 (95% confidence interval 1.00-1.26) per 1000 microg increase in the daily dose of BDP or equivalent.

Conclusion: In older adults, the relative risk of non-vertebral fractures increases by about 12% for each 1000 microg/day increase in the dose of BDP or equivalent. The magnitude of this risk was considerably less than other common risk factors for fracture in the older adult.

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