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New steroids fracture alert

GPs have been warned to avoid inhaled high-dose steroids in patients at risk of fracture after further research backed evidence of a link between the two.

Analysis of 982 patients with asthma or COPD receiving a prescription for an inhaled corticosteroid found those on more than 601mg per day had a 2.5-fold dose related increase in fracture risk.

Study leader Dr Richard Hubbard, senior lecturer in clinical epidemiology at the University of Nottingham, said: 'Our findings provide further evidence that inhaled corticosteroid use is an independent risk factor for fracture.'

In total, 187 patients had a fracture in the 9.4 years of


Results were similar after adjusting for oral corticosteroid exposure, historical fracture and bronchodilator use, and diagnosis of airflow obstruction, the study in Chest (October) showed.

Dr Peter Stott, a GP in Tadworth, Surrey, and member of the National Osteoporosis Society scientific committee, said GPs should consider alternative treatments for patients with a family history of osteoporosis, low BMI and history of corticosteroids or fracture.

'These sorts of studies are more weight to make GPs think seriously about putting people on high doses of steroids when they're already at risk of osteoporosis,' he said.

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