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Original Article
- Mineral, Bone & Muscle
Big Data Articles (National Health Insurance Service Database) - Elevated Fracture Risks in Patients Using Inhaled Corticosteroids: A Korean Nationwide Study
- Sung Hye Kong, Ae Jeong Jo, Chan Mi Park, Kyun Ik Park, Ji Eun Yun, Jung Hee Kim
- Endocrinol Metab. 2025;40(1):82-92. Published online August 30, 2024
- DOI: https://doi.org/10.3803/EnM.2024.1990
- 5,122 View
- 108 Download
- 1 Web of Science
- 2 Crossref
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Abstract
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Supplementary Material
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ePub - Background
In this comprehensive retrospective nationwide cohort study, we examined the relationships between various asthma medications and bone health, utilizing data from the National Health Insurance Service database of South Korea.
Methods
From 2015 to 2019, the relevant dataset included 168,611 individuals aged 66 years, among whom 8,747 were diagnosed with asthma. We focused on a subset of 6,173 patients, all 66-year-old women. Participants were categorized into four groups: nonusers of asthma medication (n=2,868), leukotriene antagonist users (n=2,281), inhaled corticosteroid (ICS) users (n=517), and those using a combination of ICS and long-acting beta-agonist (ICS+LABA) medication (n=507). The primary outcomes measured were the incidences of major osteoporotic fractures and hip fractures during the follow-up period.
Results
Over 2.7 years of follow-up, 615 cases of major osteoporotic fractures and 96 cases of hip fractures were recorded. ICS users exhibited a heightened risk of both injuries, with hazard ratios of 1.38 (95% confidence interval [CI], 1.18 to 1.63; P<0.001) for major osteoporotic fractures and 1.56 (95% CI, 1.33 to 1.83; P<0.001) for hip fractures. Similarly elevated risks were observed in the ICS+LABA group. Notably, the risk associated with ICS was particularly pronounced among patients with osteopenia for both fracture types. Overall, the use of ICS, alone or in combination with LABA, in patients with asthma is associated with significantly increased risks of osteoporotic fractures, especially among those with osteopenia.
Conclusion
These findings underscore the importance of considering bone health when managing asthma, especially in older patients and those with existing bone density issues. -
Citations
Citations to this article as recorded by
- Osteoporosis Awareness in Asthma Patients Using Inhaled Corticosteroids: A Cross-Sectional Study
Gülcan Öztürk, Berrin Zinnet Eraslan, Serap Diktaş Tahtasakal, Pinar Akpınar, Duygu Silte Karamanlioglu, Feyza Ünlü Özkan, İlknur Aktaş, Sevda Cömert
Sakarya Medical Journal.2025; 15(2): 93. CrossRef - Understanding Glucocorticoid-induced Osteoporosis: Causes, Effects and Management
Mozhdeh Ghamari, Farnoosh Ebrahimzadeh, Kamila Hashemzadeh
Indian Journal of Rheumatology.2025;[Epub] CrossRef
- Osteoporosis Awareness in Asthma Patients Using Inhaled Corticosteroids: A Cross-Sectional Study
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