COPD 患者和吸入皮质类固醇治疗患者的骨折和骨质疏松风险。
Risk of Fracture and Osteoporosis in Patients With COPD and Inhaled Corticosteroids Treatment.
机构信息
Medical School of Yan'an University, Yan'an 716000, Shaanxi, China.
Department of General Practice, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi, China.
出版信息
Respir Care. 2023 Nov 25;68(12):1719-1727. doi: 10.4187/respcare.10933.
BACKGROUND
There 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.
METHODS
This 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.
RESULTS
A 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], = .10) or osteoporosis risk (RR 0.93 [95% CI 0.49-1.79], = .84) in subjects with COPD.
CONCLUSIONS
ICS use did not increase the incidence of fracture or osteoporosis in subjects with COPD.
背景
吸入皮质类固醇（ICS）是否会增加 COPD 患者骨折或骨质疏松的发生率存在争议。本荟萃分析的目的是评估 ICS 治疗对 COPD 患者骨折和骨质疏松风险的影响。
方法
本研究纳入了比较 COPD 患者 ICS 与对照（非 ICS）治疗的平行组随机对照试验（RCT），并报告了包括骨折或骨质疏松在内的不良事件。研究通过 MEDLINE/PubMed、Embase 和 Cochrane Library 数据库检索，检索时间范围为 1998 年 9 月至 2022 年 9 月。对主要结局进行了汇总风险比（RR）和 95%置信区间（CI）的计算。
结果
荟萃分析共纳入了 26 项 RCT 的 61380 名参与者。ICS 暴露并未增加 COPD 患者骨折（RR 1.10 [95% CI 0.98-1.23]， =.10）或骨质疏松风险（RR 0.93 [95% CI 0.49-1.79]， =.84）的风险。
结论
ICS 治疗不会增加 COPD 患者骨折或骨质疏松的发生率。
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