• Nini Zhang, Xinhui Fan, Yuyu Zhang, Ning Xu, and Li Li.
• Medical School of Yan'an University, Yan'an 716000, Shaanxi, China.
• Respir Care. 2023 Nov 25; 68 (12): 171917271719-1727.

BackgroundThere are disputes whether inhaled corticosteroids (ICS) increase the incidence of fracture or osteoporosis among patients with COPD. The aim of this meta-analysis was to assess the effect of ICS treatment on the risk of fracture and osteoporosis in subjects with COPD.MethodsThis study included parallel-group randomized controlled trials (RCTs) comparing ICS and control (non-ICS) therapy for subjects with COPD that reported adverse events including fractures or osteoporosis. Studies were found using MEDLINE/PubMed, Embase, and Cochrane Library databases between 1998-September 2022. Pooled risk ratios (RRs) and 95% CIs were calculated for primary outcomes.ResultsA total of 61,380 participants from 26 RCTs were included in the meta-analysis. Exposure to ICS did not increase the risk of fracture (RR 1.10 [95% CI 0.98-1.23], P = .10) or osteoporosis risk (RR 0.93 [95% CI 0.49-1.79], P = .84) in subjects with COPD.ConclusionsICS use did not increase the incidence of fracture or osteoporosis in subjects with COPD.Copyright © 2023 by Daedalus Enterprises.

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