长期研究COPD口服皮质类固醇使用的不良结果
Gary Tse1,2, Benjamin Emmanuel3, Cono Ariti1
1Observational and Pragmatic Research Institute, Singapore, Singapore.
International journal of chronic obstructive pulmonary disease
|November 29, 2023
概括
口服皮质类固醇 (OCS) 增加了COPD患者的不良结果. 更高的累积剂量与更大的风险相关,包括骨质疏松症,糖尿病,心血管疾病和死亡率.
科学领域:
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 口服皮质类固醇 (OCS) 经常被处方用于慢性阻塞性肺病 (COPD) 的恶化.
- 在COPD患者中OCS的长期安全性需要进行彻底的调查.
研究的目的:
- 评估口服皮质类固醇 (OCS) 使用与慢性阻塞性肺病 (COPD) 患者各种不良结果的风险之间的关联.
- 为了确定OCS的累积剂量是否影响这些不良结果的风险.
主要方法:
- 一个观察性,个别匹配的历史队列研究,利用英国电子医疗记录 (1987-2019).
- 相关临床实践研究数据链 (CPRD) 和医院情节统计 (HES) 数据被使用.
- 比例危险回归分析了OCS暴露与非暴露的COPD患者中17种不良结果的风险.
主要成果:
- 与非OCS队列相比,OCS队列表现出多种不良结果的风险更高.
- 对骨质疏松症有/没有骨折 (aHR 1.80),2型糖尿病 (aHR 1.44),心血管/脑血管疾病 (aHR 1.26) 和全因死亡率 (aHR 1.04) 观察到显著增加的风险.
- 大多数不良结果的风险随着OCS累积剂量的增加而升级.
结论:
- 任何口服皮质类固醇 (OCS) 在COPD患者的使用都与不良结果的风险增加有关.
- 这些不良事件的风险通常与较高的OCS累积剂量相称增加.
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