Asthma drugs not linked to fracture risk: study

By Will Boggs, MD

NEW YORK (Reuters Health) - Inhaled and oral bronchodilators do not appear to increase the risk of fracture in people with chronic lung disease, according to Danish investigators who suggest that the "severity of the underlying lung disease" may be responsible.

"Inhaled drugs are safe; therefore, the focus should be on preventing use of large doses of oral corticosteroids for prolonged periods of time," Dr. Peter Vestergaard from Aarhus University Hospital, told Reuters Health. These patients "may perhaps better be managed with the inhaled preparations in terms of bone safety," he added.

Vestergaard and colleagues investigated whether the use of any bronchodilator or other lung active drug for asthma, COPD (chronic obstructive pulmonary disease), emphysema, or other lung disease was associated with a change in the risk of fractures in nearly 250,000 patients residing in Denmark in 2000. Each patient was matched with three controls from the general population.

The risk of fracture was higher in patients with COPD, emphysema, and other chronic lung disease than in patients with asthma, they report in the journal Chest.

There was a "dose-dependent" relationship between oral steroids and an increased fracture risk, the report indicates, but no other drugs were associated with fracture risk.

There was also an increased risk of fracture associated with inhaled short-acting beta-agonists, but, the investigators say, this increased risk is likely associated with the severity of the underlying lung disease for which the drugs are administered.

"Focus needs to be maintained on the bone health of patients with lung disease," Vestergaard advised.

SOURCE: Chest, November 2007.