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Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study

Studies have shown increased nontuberculous mycobacterial pulmonary disease (NTM) incidence with inhaled corticosteroid (ICS) use in patients with chronic respiratory diseases; however, this association in chronic obstructive pulmonary disease (COPD) remains insufficiently studied. Using a nationwid...

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Autores principales: Yu, Iseul, Hong, Se Hwa, Chang, Min-Seok, Lee, Seok Jeong, Yong, Suk Joong, Lee, Won-Yeon, Kim, Sang-Ha, Lee, Ji-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382049/
https://www.ncbi.nlm.nih.gov/pubmed/37511700
http://dx.doi.org/10.3390/jpm13071088
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author Yu, Iseul
Hong, Se Hwa
Chang, Min-Seok
Lee, Seok Jeong
Yong, Suk Joong
Lee, Won-Yeon
Kim, Sang-Ha
Lee, Ji-Ho
author_facet Yu, Iseul
Hong, Se Hwa
Chang, Min-Seok
Lee, Seok Jeong
Yong, Suk Joong
Lee, Won-Yeon
Kim, Sang-Ha
Lee, Ji-Ho
author_sort Yu, Iseul
collection PubMed
description Studies have shown increased nontuberculous mycobacterial pulmonary disease (NTM) incidence with inhaled corticosteroid (ICS) use in patients with chronic respiratory diseases; however, this association in chronic obstructive pulmonary disease (COPD) remains insufficiently studied. Using a nationwide population-based database of the Korean National Health Insurance Service, newly diagnosed COPD patients (2005–2018) treated with inhaled bronchodilators were selected. An NTM case was defined by the presence of the first diagnostic code following inhaled bronchodilator use. Results indicated that ICS users did not have an increased risk of NTM disease compared to non-ICS users (hazard ratio (HR), 1.121; 95% confidence interval (CI), 0.950–1.323; p = 0.176). However, in a subgroup analysis, the highest quartile of the cumulative ICS dose was associated with the development of NTM (1.200, 0.950–1.323, p = 0.050). Medium (1.229, 1.008–1.499, p = 0.041) and high daily doses of ICS (1.637, 1.241–2.160, p < 0.001) were associated with an increased risk of NTM disease. There was no difference in the risk of NTM according to ICS type. ICS use may increase the risk of developing NTM disease in patients with COPD. Physicians should weigh the potential benefits and risks of ICS, especially when using high doses and prolonged durations.
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spelling pubmed-103820492023-07-29 Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study Yu, Iseul Hong, Se Hwa Chang, Min-Seok Lee, Seok Jeong Yong, Suk Joong Lee, Won-Yeon Kim, Sang-Ha Lee, Ji-Ho J Pers Med Article Studies have shown increased nontuberculous mycobacterial pulmonary disease (NTM) incidence with inhaled corticosteroid (ICS) use in patients with chronic respiratory diseases; however, this association in chronic obstructive pulmonary disease (COPD) remains insufficiently studied. Using a nationwide population-based database of the Korean National Health Insurance Service, newly diagnosed COPD patients (2005–2018) treated with inhaled bronchodilators were selected. An NTM case was defined by the presence of the first diagnostic code following inhaled bronchodilator use. Results indicated that ICS users did not have an increased risk of NTM disease compared to non-ICS users (hazard ratio (HR), 1.121; 95% confidence interval (CI), 0.950–1.323; p = 0.176). However, in a subgroup analysis, the highest quartile of the cumulative ICS dose was associated with the development of NTM (1.200, 0.950–1.323, p = 0.050). Medium (1.229, 1.008–1.499, p = 0.041) and high daily doses of ICS (1.637, 1.241–2.160, p < 0.001) were associated with an increased risk of NTM disease. There was no difference in the risk of NTM according to ICS type. ICS use may increase the risk of developing NTM disease in patients with COPD. Physicians should weigh the potential benefits and risks of ICS, especially when using high doses and prolonged durations. MDPI 2023-06-30 /pmc/articles/PMC10382049/ /pubmed/37511700 http://dx.doi.org/10.3390/jpm13071088 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yu, Iseul
Hong, Se Hwa
Chang, Min-Seok
Lee, Seok Jeong
Yong, Suk Joong
Lee, Won-Yeon
Kim, Sang-Ha
Lee, Ji-Ho
Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study
title Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study
title_full Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study
title_fullStr Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study
title_full_unstemmed Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study
title_short Inhaled Corticosteroids and the Risk of Nontuberculous Mycobacterial Pulmonary Disease in Chronic Obstructive Pulmonary Disease: Findings from a Nationwide Population-Based Study
title_sort inhaled corticosteroids and the risk of nontuberculous mycobacterial pulmonary disease in chronic obstructive pulmonary disease: findings from a nationwide population-based study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382049/
https://www.ncbi.nlm.nih.gov/pubmed/37511700
http://dx.doi.org/10.3390/jpm13071088
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