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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
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Inhaled Corticosteroids and Non-Tuberculous Mycobacteria Risk in Patients with COPD.

Emma Moerk Borremose1, Victor Naestholt Dahl2,3, Anna Kubel Vognsen1

  • 1Copenhagen Respiratory Research, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark.

Journal of Clinical Medicine
|May 13, 2026
PubMed
Summary
This summary is machine-generated.

Inhaled corticosteroids (ICS) increase the risk of non-tuberculous mycobacteria (NTM) isolation in patients with chronic obstructive pulmonary disease (COPD). This risk is dose-dependent, with higher ICS doses posing a greater risk, particularly at high doses.

Keywords:
chronic obstructive pulmonary diseaseinhaled corticosteroidsnon-tuberculous mycobacteria

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Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Inhaled corticosteroids (ICS) are associated with increased pneumonia risk in COPD patients.
  • Limited evidence suggests ICS may also increase non-tuberculous mycobacteria (NTM) infection risk.

Purpose of the Study:

  • To investigate the association between ICS treatment and NTM isolation in patients diagnosed with chronic obstructive pulmonary disease (COPD).

Main Methods:

  • Retrospective cohort study of 120,006 COPD patients (2008-2021).
  • ICS exposure assessed via redeemed prescriptions, categorized by budesonide-equivalent dose (none, low, medium, high).
  • Cause-specific Cox regression with competing risks, adjusted for confounders; sensitivity analyses performed.

Main Results:

  • Medium- and high-dose ICS were linked to increased NTM isolation hazard (HR 1.39 and 1.52, respectively).
  • The association with high-dose ICS remained significant in sensitivity analyses.
  • 0.32% of patients experienced NTM isolation during a median 4.9-year follow-up.

Conclusions:

  • ICS treatment in COPD patients is associated with a dose-dependent increased hazard of NTM isolation.
  • High-dose ICS use warrants caution due to this increased risk.
  • Further research may be needed to elucidate mechanisms and clinical implications.