Inhaled corticosteroids and the increased risk of pulmonary tuberculosis: a population-based case-control study

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Pharmacology

Background:

• The relationship between inhaled corticosteroid (ICS) use and the incidence of pulmonary tuberculosis (TB) remains unclear.
• Investigating potential risk factors for TB is crucial for public health initiatives.

Purpose of the Study:

• To determine if ICS use is associated with an increased risk of developing TB.
• To quantify the risk of TB development in patients using ICS.

Main Methods:

• A population-based case-control study was conducted using Taiwan's National Health Insurance Research Database (NHIRD) from 2002 to 2010.
• 8091 TB patients were matched with 32,364 controls, with medication and comorbidity data analyzed for the preceding 5 years.
• Multiple logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Main Results:

• Adjusted analysis revealed that ICS use was associated with a 2.04-fold increased risk of TB development (aOR: 2.04, 95% CI: 1.78-2.33).
• Both ICS and oral corticosteroids (OCS) were independent risk factors, showing a dose-response relationship with TB development.
• A history of TB was the strongest comorbidity risk factor for developing TB (aOR: 8.50, 95% CI: 7.52-9.61).

Conclusions:

• Long-term use of inhaled corticosteroids (ICS) may be a significant risk factor for developing pulmonary tuberculosis.
• The findings highlight the need for careful consideration of ICS therapy in individuals at risk for TB.