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Association Between Inhaled Corticosteroids and Tracheobronchomalacia
Varun Shah1, Bryan Husta2, Atul Mehta3
1Pulmonary and Critical Care Division, Lenox Hill Hospital, New York, NY.
Chest
|January 25, 2020
Summary
High-dose inhaled corticosteroids (ICS) used for extended periods are associated with an increased risk of tracheobronchomalacia (TBM). Further research is needed to confirm this link.
Area of Science:
- Pulmonology
- Respiratory Medicine
Background:
- Tracheobronchomalacia (TBM) is a condition characterized by weakness of the airway walls.
- Inhaled corticosteroids (ICS) are commonly used to manage chronic respiratory diseases like asthma and COPD.
Purpose of the Study:
- To investigate the potential association between the use of inhaled corticosteroids (ICS) and the development of tracheobronchomalacia (TBM).
Main Methods:
- Retrospective analysis of 463 patients with asthma and COPD.
- Diagnosis of TBM confirmed via CT imaging and/or flexible bronchoscopy.
- Logistic regression models used to assess associations with TBM, including steroid dose and duration.
Main Results:
- Higher doses and longer duration of ICS use were significantly associated with an increased odds of TBM.
- Multivariate analysis showed a 3.5-fold increased odds of TBM in patients on high-dose steroids compared to those not on steroids.
- Factors like age, GERD, LAMA use, and pulmonary disease type also correlated with TBM.
Conclusions:
- A significant association exists between prolonged, high-dose ICS use and TBM.
- Prospective randomized controlled trials are recommended to establish causality.
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