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One concern about inhaled corticosteroids is that long-term use might cause osteoporosis, a well-known adverse effect of systemic steroids. In the previously published industry-funded TORCH trial, patients with moderate-to-severe chronic obstructive pulmonary disease were randomized to receive inhaled corticosteroid (fluticasone), β-agonist (salmeterol), combination therapy, or placebo (JW Gen Med Feb 21 2007). Now, in a substudy of 658 TORCH participants, researchers report serial measurements of bone-mineral density (BMD) for 3 years. Only about half the patients completed all testing, a typical occurrence in studies of patients with advanced COPD.
At baseline, 18% of men and 30% of women had osteoporosis (BMD T-score ≤–2.5). During 3 year…