Patients with COPD who use inhaled corticosteroids to improve breathing for more than 6 months have a 27% increased risk for bone fractures. The risk goes up as the dosage increases. It was previously assumed that inhaled steroids would have a predominantly local effect, but now we know this is not true. Treatment should consist of lowering or discontinuing inhaled steroids and supporting bone growth with weight bearing exercise and nutritionally with vitamins D and K, calcium with micronutrients, and strontium.
