Inhaled corticosteroids (ICS) are often used to relieve the symptoms of chronic obstructive pulmonary disease (COPD). Millions of COPD patients have used this type of medication for long-term treatment of the disease. But a recent study led by researchers at Johns Hopkins suggests that patients who use inhaled corticosteroids for a long time have a higher risk of bone fractures.
COPD is a broad term used for chronic breathing disorders including chronic bronchitis and emphysema.
• Emphysema is a condition in which the tiny air sacs inside the lungs are damaged or destroyed. When this happens, the lungs lose elasticity and cannot force stale air out to make room for fresh air. Patients with emphysema are not able to get the oxygen they need and often feel breathless.
Some patients with COPD have both chronic bronchitis and emphysema.
Inhaled corticosteroids are a standard part of treatment for patients with COPD. ICS medications are very strong anti-inflammatories which help reduce swelling in the airways and slow mucus production. They can also help reduce sensitivity to allergens that also trigger mucus production and swelling.
Inhaled corticosteroids have been considered safer than oral steroids because ICS work directly in the lungs without entering the bloodstream. However, researchers at John Hopkins noted a connection between patients who used ICS to treat COPD and an increased risk of bone fractures. The research team reviewed the results of multiple research studies that included over 86,000 patients. In all the studies, they found a significantly higher risk for fractures in patients who used ICS over those who did not. They also noted that as the inhaled corticosteroid dose increased, the risk of fractures also went up.
The drugs considered in the study were fluticasone which is used in Advair and budesonide which is used in Symbicort.