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Corticosteroids and hip fracture risk in elderly respiratory patients: EPIC-Greece cohort

Karakatsani, A; Katsoulis, M; Klinaki, E; Trichopoulou, A; (2017) Corticosteroids and hip fracture risk in elderly respiratory patients: EPIC-Greece cohort. Advances in Respiratory Medicine , 85 (1) pp. 22-27. 10.5603/ARM.2017.0005. Green open access

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Abstract

INTRODUCTION: In an ageing population the prevalence of osteoporosis and chronic respiratory diseases is expected to increase in the near future. Interestingly, several forms of corticosteroids, drugs implicated in osteoporosis pathogenesis, are prescribed to respiratory patients without taking into consideration their age and risk for osteoporotic fractures. The aim of this study was to investigate the risk for hip fracture of the elder individuals who are taking corticosteroids for respiratory disease, including inhalers. MATERIAL AND METHODS: Data on incident hip fractures were collected through the active follow-up for all individuals participating in the Greek segment of the European Prospective Investigation into Cancer and Nutrition (EPIC-Greece) study who were 60 years or older at recruitment and reported "a doctor's diagnosis" of respiratory disease. Socio-demographic, life-style, health status data and use of corticosteroids were recorded from the baseline and follow-up questionnaires. Cox regression models were applied to estimate hazard ratios (HRs) adjusting for relevant confounders. RESULTS: We observed an increase in hip fracture risk with corticosteroid intake overall (HR: 1.68, 95% CI: 0.85-3.34). Increased risk persisted when we restricted our analysis to participants taking any form of corticosteroids for obstructive lung disease (HR: 1.40, 95% CI: 0.64-3.06) and to those using only inhalers (HR: 1.58, 95% CI: 0.71-3.50). However, these positive associations did not reach the nominal level of significance probably due to the small number of participants with hip fractures during follow-up. CONCLUSION: Hip fracture risk should be taken into consideration when recommending corticosteroids to the elder respiratory patients, including inhalers.

Type: Article
Title: Corticosteroids and hip fracture risk in elderly respiratory patients: EPIC-Greece cohort
Location: Poland
Open access status: An open access version is available from UCL Discovery
DOI: 10.5603/ARM.2017.0005
Publisher version: http://dx.doi.org/10.5603/ARM.2017.0005
Language: English
Additional information: This is an Open Access article published under the Creative Commons Attribution-Non Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: EPIC-Greece, corticosteroids, elderly, hip fracture, respiratory disease
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology
URI: https://discovery.ucl.ac.uk/id/eprint/1557726
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