Hip fracture risk with corticosteroids in patients with COPD: a systematic review and meta-analysis

Abstract Background: Chronic obstructive pulmonary disease (COPD) is a complex respiratory disease. The risk of osteoporosis and fragility fractures can increase in COPD patients treated with glucocorticoids.Objectives: The purpose of this systematic review and meta-analysis was to investigate the relationship between the risk of hip fractures and patients with COPD treated with corticosteroidsMethods: We searched both randomized controlled trials (RCTs) and observational studies (case-control, prospective cohort or retrospective cohort) of hip fractures in patients with COPD. A meta-analysis was performed to calculate the odds ratio (OR) with 95% confidence intervals (CI) employing a random effect (RE) model or fixed effect (FE) model. Review Manager 5.3 was used for statistical analysis.Results: The risk of hip fractures significantly increased in patients with COPD compared to patients without COPD. (OR: 1.38; 95% CI: 1.15-1.66; p=0.09; I2=43%). Patient treated with oral corticosteroids (OCS) has a significantly higher risk of hip fractures (OR: 1.45; 95% CI: 1.36-1.55).Conclusion: The result of this meta-analysis showed that there is a significantly increased risk of hip fracture among patients with COPD.