Ng BC, Leslie WD, Johnson KM, et al. - The Manitoba bone mineral density (BMD) registry study was conducted to evaluate the impacts of long-term inhaled corticosteroid treatment on fragility fractures in older women. Manitoba health administrative databases and the provincial BMD registry (1996–2013) were applied to distinguish women ≥ 40 years of age with asthma and/or chronic obstructive pulmonary disease (COPD) within 3 years preceding the baseline BMD test. They assessed inhaled corticosteroids (ICS) use, stratified by exposure tertiles, within the 12-month period following the baseline BMD test (by total days and quantity, primary outcome), and over the entire follow-up period (by medication possession ratio and average annual dose, secondary outcome). A Cox proportional hazards model was applied to calculate the hazard ratio of fracture with ICS use, controlling for baseline determinants of fracture. This study included a total of 6880 older women with asthma (38%) or COPD (62%). The data do not support an elevated risk of major osteoporotic fracture in older women with chronic respiratory diseases due to long-term ICS use.