The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary Disease
Ji Won Park,1,* Yoonki Hong,2,* Chin Kook Rhee,3 Hye Sook Choi,4 Kyungjoo Kim,3 Kwang Ha Yoo,5 Ki-Suck Jung,6 Joo Hun Park1 1Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea; 2Department of Internal Medicine, Kangwon National...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-05-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-impact-of-inhaled-corticosteroids-on-the-prognosis-of-chronic-obst-peer-reviewed-fulltext-article-COPD |
| _version_ | 1827955333036769280 |
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| author | Park JW Hong Y Rhee CK Choi HS Kim K Yoo KH Jung KS Park JH |
| author_facet | Park JW Hong Y Rhee CK Choi HS Kim K Yoo KH Jung KS Park JH |
| author_sort | Park JW |
| collection | DOAJ |
| description | Ji Won Park,1,* Yoonki Hong,2,* Chin Kook Rhee,3 Hye Sook Choi,4 Kyungjoo Kim,3 Kwang Ha Yoo,5 Ki-Suck Jung,6 Joo Hun Park1 1Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea; 2Department of Internal Medicine, Kangwon National University, Chuncheon, South Korea; 3Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; 4Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, South Korea; 5Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea; 6Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea*These authors contributed equally to this workCorrespondence: Joo Hun Park, Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Worldcup road 164, Suwon, Gyeonggi-do, 16499, South Korea, Tel +82-31-219-5116 ; +82-10-8379-8299, Fax +82-31-219-5124, Email jhpamc@naver.com; jhpamc@hanmail.netBackground: A comprehensive analysis of the effects of inhaled corticosteroids (ICS) on COPD in a real-world setting is required due to safety concerns regarding ICS in COPD. This study aimed to explore the impact of ICS on the prognosis of Asian COPD patients in the real-life world.Methods: We examined 978 COPD patients registered in the Korean National Health and Nutrition Examination Survey (KNHANES) database and with their data linked to Health Insurance and Review Assessment (HIRA) data. The outcome measures were ascertained by HIRA from January 1, 2009, to December 31, 2012. This study enrolled two arms; ICS users (N = 85, mean age = 66.7 ± 8.9 years) and non-ICS users (N = 893, mean age = 63.7 ± 9.7 years).Results: Compared to the non-ICS users, the ICS users had a higher rate of pneumonia, tuberculosis, and acute exacerbations (P< 0.05). Hospitalization due to respiratory causes was also higher among ICS users (P< 0.05). Multivariate analysis showed that acute exacerbation was independently associated with the development of pneumonia (P< 0.05), whereas ICS therapy had a tendency to be associated with pneumonia. Another multivariate analysis demonstrated that old age, FEV1, ICS therapy, and pneumonia were independently associated with the occurrence of acute exacerbation (P< 0.05). The concomitant pneumonia (HR = 3.353, P = 0.004) was independently associated with higher mortality (P< 0.05).Conclusion: Our data demonstrated that the ICS users had a higher rate of pneumonia and tuberculosis and the concomitant pneumonia was independently associated with higher mortality, highlighting the importance of cautious and targeted administration of ICS in COPD.Keywords: COPD, inhaled corticosteroids, pneumonia, mortality |
| first_indexed | 2024-04-09T14:45:14Z |
| format | Article |
| id | doaj.art-12d60de24b3e4e08b41b8973721a414e |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-04-09T14:45:14Z |
| publishDate | 2023-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-12d60de24b3e4e08b41b8973721a414e2023-05-02T18:20:13ZengDove Medical PressInternational Journal of COPD1178-20052023-05-01Volume 1873374383439The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary DiseasePark JWHong YRhee CKChoi HSKim KYoo KHJung KSPark JHJi Won Park,1,* Yoonki Hong,2,* Chin Kook Rhee,3 Hye Sook Choi,4 Kyungjoo Kim,3 Kwang Ha Yoo,5 Ki-Suck Jung,6 Joo Hun Park1 1Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea; 2Department of Internal Medicine, Kangwon National University, Chuncheon, South Korea; 3Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; 4Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, South Korea; 5Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea; 6Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea*These authors contributed equally to this workCorrespondence: Joo Hun Park, Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Worldcup road 164, Suwon, Gyeonggi-do, 16499, South Korea, Tel +82-31-219-5116 ; +82-10-8379-8299, Fax +82-31-219-5124, Email jhpamc@naver.com; jhpamc@hanmail.netBackground: A comprehensive analysis of the effects of inhaled corticosteroids (ICS) on COPD in a real-world setting is required due to safety concerns regarding ICS in COPD. This study aimed to explore the impact of ICS on the prognosis of Asian COPD patients in the real-life world.Methods: We examined 978 COPD patients registered in the Korean National Health and Nutrition Examination Survey (KNHANES) database and with their data linked to Health Insurance and Review Assessment (HIRA) data. The outcome measures were ascertained by HIRA from January 1, 2009, to December 31, 2012. This study enrolled two arms; ICS users (N = 85, mean age = 66.7 ± 8.9 years) and non-ICS users (N = 893, mean age = 63.7 ± 9.7 years).Results: Compared to the non-ICS users, the ICS users had a higher rate of pneumonia, tuberculosis, and acute exacerbations (P< 0.05). Hospitalization due to respiratory causes was also higher among ICS users (P< 0.05). Multivariate analysis showed that acute exacerbation was independently associated with the development of pneumonia (P< 0.05), whereas ICS therapy had a tendency to be associated with pneumonia. Another multivariate analysis demonstrated that old age, FEV1, ICS therapy, and pneumonia were independently associated with the occurrence of acute exacerbation (P< 0.05). The concomitant pneumonia (HR = 3.353, P = 0.004) was independently associated with higher mortality (P< 0.05).Conclusion: Our data demonstrated that the ICS users had a higher rate of pneumonia and tuberculosis and the concomitant pneumonia was independently associated with higher mortality, highlighting the importance of cautious and targeted administration of ICS in COPD.Keywords: COPD, inhaled corticosteroids, pneumonia, mortalityhttps://www.dovepress.com/the-impact-of-inhaled-corticosteroids-on-the-prognosis-of-chronic-obst-peer-reviewed-fulltext-article-COPDcopdinhaled corticosteroidspneumoniamortality |
| spellingShingle | Park JW Hong Y Rhee CK Choi HS Kim K Yoo KH Jung KS Park JH The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary Disease International Journal of COPD copd inhaled corticosteroids pneumonia mortality |
| title | The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary Disease |
| title_full | The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary Disease |
| title_fullStr | The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary Disease |
| title_full_unstemmed | The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary Disease |
| title_short | The Impact of Inhaled Corticosteroids on the Prognosis of Chronic Obstructive Pulmonary Disease |
| title_sort | impact of inhaled corticosteroids on the prognosis of chronic obstructive pulmonary disease |
| topic | copd inhaled corticosteroids pneumonia mortality |
| url | https://www.dovepress.com/the-impact-of-inhaled-corticosteroids-on-the-prognosis-of-chronic-obst-peer-reviewed-fulltext-article-COPD |
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