Individuals who use some of the most popular inhalers to combat the symptoms of chronic obstructive pulmonary disease (COPD) may face an increased risk of bone fractures, according to the findings of a new study.
Chinese researchers say inhalers like Pulmicort and Advair, which contain corticosteroids, could increase a person’s risk of bone fractures by 19%. That risk could increase to nearly 50% if they are using double or triple-strength inhalers, the researchers warn in findings published this month in the journal BMC Pulmonary Medicine.
COPD is a group of lung diseases that include emphysema and chronic bronchitis. The conditions stem from inflammatory lung symptoms like blocked lung airflow and difficulty breathing. Damage to the lungs is permanent and cannot be reversed, and regular symptoms include shortness of breath, wheezing, or chronic cough.
Roughly 16 million Americans currently live with COPD. There is no cure for the disease, but it can be treated to reduce symptoms and discomfort. Corticosteroid inhalers are often used to prevent the symptoms of asthma and COPD and help to reduce inflammation in the lungs.
COPD Inhaler Bone Fracture Risks
In this new study, researchers from China conducted a systematic review and meta-analysis of 44 randomized control trials involving nearly 88,000 patients, looking for fracture risks for COPD patients treated with inhaled corticosteroids.
According to their findings, using corticosteroid inhalers increased a person’s risk of suffering a bone fracture by 19%. The risk was greater if the patient was using combination therapy or triple therapy. Combination therapy, the use of inhaled corticosteroids and long-acting beta-agonists (LABA), increased the risk by 30%.
The highest risk was seen among those using triple therapy or inhaled corticosteroids, combined with two LABA medications plus a long-acting muscarinic antagonist, who faced a 49% increased risk of bone fractures.
Patients who were treated with inhaled corticosteroids for longer than 12 months, who were older, and who had Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II disease also faced a significantly increased risk of bone fractures.
Using budesonide, the active ingredient in Pulmicort, and fluticasone therapy, sold under the brand name Advair, were also linked with an increased fracture risk. Previous studies have also warned that Pulmicort may increase the risk of death among infants.