Unintended effects of inhaled corticosteroids : disease or drugs?

Abstract

Patients with asthma or COPD are often treated with inhaled corticosteroids. These drugs reduce the inflammation in the lungs and patients suffer fewer exacerbations. In the late nineties, a tendency to treat patients in general with higher doses of inhaled corticosteroids was accompanied with an increased attention to systemic side effects. Previous studies have linked the intake of high doses of inhaled corticosteroids with porous bones and risk of fracture. However, patients using high doses of inhaled corticosteroids often have more severe asthma or COPD. In this thesis, it was found that patients using high doses of inhaled corticosteroids were at greater risk of fracture. Howver, this was largely explained by the severity of the respiratory disease instead of a causal effect of inhaled corticosteroids.