在患有慢性阻塞性肺部疾病的个体中,与吸入性皮质类固醇使用相关的不良结果
Wilson D Pace1, Elisabeth Callen2, Gabriela Gaona-Villarreal2
1DARTNet Institute, Aurora, Colorado Wilson.pace@dartnet.info.
Annals of family medicine
|March 24, 2025
概括
在慢性阻塞性肺病 (COPD) 管理中长期使用吸入性皮质类固醇 (ICS) 显著增加了严重健康问题的风险,包括糖尿病,肺炎和骨折.
科学领域:
- 肺部医学 肺部医学
- 药物监督 药物监督 药物监督
- 临床流行病学 临床流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 管理通常涉及吸入性皮质类固醇 (ICS).
- 了解ICS的长期安全概况对于优化COPD治疗策略至关重要.
- 以前的研究表明,与ICS使用相关的潜在不良影响.
研究的目的:
- 评估与慢性阻塞性肺病 (COPD) 患者吸入性皮质类固醇 (ICS) 使用相关的长期风险.
- 为了比较COPD患者长期和短期ICS暴露之间的特定不良结果的发生率.
主要方法:
- 分析了45岁以上的COPD患者的电子健康记录数据.
- 根据COPD诊断时间定义了两个队列,流行和开始.
- 在长期 (> 24 个月) 和短期 (< 4 个月) ICS 用户之间进行了综合结局 (二型糖尿病,白内障,肺炎,骨质疏松症,骨折) 和复发事件 (肺炎,骨折) 的比较.
主要成果:
- 这项研究包括318,385名 (流行) 和209,062名 (开始) 个体.
- 长期使用ICS在流行 (HR=2.65) 和开始 (HR=2.60) 队列中显著与更高的复合结果相关.
- 在长期ICS暴露的两组中,观察到复发性肺炎和复发性骨折的风险增加.
结论:
- 对COPD的长期吸入性皮质类固醇 (ICS) 治疗与较高的重大不良事件发生率有关.
- 这些风险包括2型糖尿病,白内障,肺炎,骨质疏松症和骨折.
- 这些发现强调了在COPD管理中仔细考虑ICS持续时间的重要性.
更多相关视频
相关概念视频
01:26COPD: Management Using Bronchodilators and Corticosteroids
163
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...
163
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
180
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
180
01:22Chronic Obstructive Pulmonary Disease
1.1K
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
1.1K
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
2.7K
Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
Chronic Inflammation
Chronic Inflammation
2.7K
01:23Inhaled Medications
210
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...
210
01:29Chronic Obstructive Pulmonary Disease-V: Management
2.5K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.5K