Patients with chronic obstructive pulmonary disease (COPD) who were current high-dose users of inhaled corticosteroids (ICS) had an increased risk of nonvertebral fractures compared with those who had no exposure, according to a study in the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine. The researchers looked at 1,708 COPD patients with a nonvertebral fracture who were matched with 6,817 COPD control subjects without a fracture. (In COPD, patients have persistent obstruction of the airways, associated with either severe emphysema or chronic bronchitis. Most such illnesses result from years of cigarette smoking.) Treatment with the inhaled form of corticosteroids is intended to deliver medication directly to the lungs (involved site) and to limit any systemic effects. Patients classified as current users who were exposed to ICS at high daily doses were at the highest risk for nonvertebral fractures. In the highest dose category, the average daily dose was 1,616 micrograms per day. The investigators point out that the increase in fracture risk associated with ICS use did not by itself warrant stoppage of treatment in patients with COPD. Rather, the risk of fractures indicated that physicians should consider prescribing the lowest effective dose of ICS in the management of COPD. Also, they pointed out that the frail nature of many COPD patients who have various chronic diseases makes them even more impacted by ICS use.

GREATER ACETAMINOPHEN USE CAN LEAD TO NEWLY DIAGNOSED ASTHMA IN WOMEN

During 6 years of follow-up of participants in the Nurses Health Study, investigators found that greater use of the analgesic acetaminophen was prospectively associated with an increased rate of new physician diagnosis of adult-onset asthma. Acetaminophen is a widely used nonprescription analgesic sold under
'"/>

Contact: Cathy Carlomagno
ccarlomagno@thoracic.org
212-315-6442
American Thoracic Society
26-Mar-2004