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Inhaled corticosteroids can reduce osteoporosis in female patients with COPD

BACKGROUND: Whether the use of inhaled corticosteroids (ICSs) in patients with COPD can protect from osteoporosis remains undetermined. The aim of this study is to assess the incidence of osteoporosis in patients with COPD with ICS use and without. PATIENTS AND METHODS: This is a retrospective cohor...

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Autores principales: Liu, Shih-Feng, Kuo, Ho-Chang, Liu, Guan-Heng, Ho, Shu-Chen, Chang, Huang-Chih, Huang, Hung-Tu, Chen, Yu-Mu, Huang, Kuo-Tung, Chen, Kuan-Yi, Fang, Wen-Feng, Lin, Meng-Chih
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951067/
https://www.ncbi.nlm.nih.gov/pubmed/27478374
http://dx.doi.org/10.2147/COPD.S106054
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author Liu, Shih-Feng
Kuo, Ho-Chang
Liu, Guan-Heng
Ho, Shu-Chen
Chang, Huang-Chih
Huang, Hung-Tu
Chen, Yu-Mu
Huang, Kuo-Tung
Chen, Kuan-Yi
Fang, Wen-Feng
Lin, Meng-Chih
author_facet Liu, Shih-Feng
Kuo, Ho-Chang
Liu, Guan-Heng
Ho, Shu-Chen
Chang, Huang-Chih
Huang, Hung-Tu
Chen, Yu-Mu
Huang, Kuo-Tung
Chen, Kuan-Yi
Fang, Wen-Feng
Lin, Meng-Chih
author_sort Liu, Shih-Feng
collection PubMed
description BACKGROUND: Whether the use of inhaled corticosteroids (ICSs) in patients with COPD can protect from osteoporosis remains undetermined. The aim of this study is to assess the incidence of osteoporosis in patients with COPD with ICS use and without. PATIENTS AND METHODS: This is a retrospective cohort and population-based study in which we extracted newly diagnosed female patients with COPD between 1997 and 2009 from Taiwan’s National Health Insurance (TNHI) database between 1996 and 2011 (International Classification of Diseases, Ninth Revision – Clinical Modification [ICD-9-CM] 491, 492, 496). The patients with COPD were defined by the presence of two or more diagnostic codes for COPD within 12 months on either inpatient or outpatient service claims submitted to TNHI. Patients were excluded if they were younger than 40 years or if osteoporosis had been diagnosed prior to the diagnosis of COPD and cases of asthma (ICD-9 CM code 493.X) before the index date. These enrolled patients were followed up till 2011, and the incidence of osteoporosis was determined. The Cox proportional hazards regression model was also used to estimate hazard ratios (HRs) for incidences of lung cancer. RESULTS: Totally, 10,723 patients with COPD, including ICS users (n=812) and nonusers (n=9,911), were enrolled. The incidence rate of osteoporosis per 100,000 person years is 4,395 in nonusers and 2,709 in ICS users (HR: 0.73, 95% confidence interval [CI]: 0.63–084). The higher ICS dose is associated with lower risk of osteoporosis (0 mg to ≤20 mg, HR: 0.84, 95% CI: 0.69–1.04; >20 mg to ≤60 mg, HR: 0.78, 95% CI: 0.59–1.04; and >60 mg, HR: 0.72, 95% CI: 0.55–0.96; P for trend =0.0023) after adjusting for age, income, and medications. The cumulative osteoporosis probability significantly decreased among the ICS users when compared with the nonusers (P<0.001). CONCLUSION: Female patients with COPD using ICS have a dose–response protective effect for osteoporosis.
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spelling pubmed-49510672016-07-29 Inhaled corticosteroids can reduce osteoporosis in female patients with COPD Liu, Shih-Feng Kuo, Ho-Chang Liu, Guan-Heng Ho, Shu-Chen Chang, Huang-Chih Huang, Hung-Tu Chen, Yu-Mu Huang, Kuo-Tung Chen, Kuan-Yi Fang, Wen-Feng Lin, Meng-Chih Int J Chron Obstruct Pulmon Dis Original Research BACKGROUND: Whether the use of inhaled corticosteroids (ICSs) in patients with COPD can protect from osteoporosis remains undetermined. The aim of this study is to assess the incidence of osteoporosis in patients with COPD with ICS use and without. PATIENTS AND METHODS: This is a retrospective cohort and population-based study in which we extracted newly diagnosed female patients with COPD between 1997 and 2009 from Taiwan’s National Health Insurance (TNHI) database between 1996 and 2011 (International Classification of Diseases, Ninth Revision – Clinical Modification [ICD-9-CM] 491, 492, 496). The patients with COPD were defined by the presence of two or more diagnostic codes for COPD within 12 months on either inpatient or outpatient service claims submitted to TNHI. Patients were excluded if they were younger than 40 years or if osteoporosis had been diagnosed prior to the diagnosis of COPD and cases of asthma (ICD-9 CM code 493.X) before the index date. These enrolled patients were followed up till 2011, and the incidence of osteoporosis was determined. The Cox proportional hazards regression model was also used to estimate hazard ratios (HRs) for incidences of lung cancer. RESULTS: Totally, 10,723 patients with COPD, including ICS users (n=812) and nonusers (n=9,911), were enrolled. The incidence rate of osteoporosis per 100,000 person years is 4,395 in nonusers and 2,709 in ICS users (HR: 0.73, 95% confidence interval [CI]: 0.63–084). The higher ICS dose is associated with lower risk of osteoporosis (0 mg to ≤20 mg, HR: 0.84, 95% CI: 0.69–1.04; >20 mg to ≤60 mg, HR: 0.78, 95% CI: 0.59–1.04; and >60 mg, HR: 0.72, 95% CI: 0.55–0.96; P for trend =0.0023) after adjusting for age, income, and medications. The cumulative osteoporosis probability significantly decreased among the ICS users when compared with the nonusers (P<0.001). CONCLUSION: Female patients with COPD using ICS have a dose–response protective effect for osteoporosis. Dove Medical Press 2016-07-14 /pmc/articles/PMC4951067/ /pubmed/27478374 http://dx.doi.org/10.2147/COPD.S106054 Text en © 2016 Liu et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Liu, Shih-Feng
Kuo, Ho-Chang
Liu, Guan-Heng
Ho, Shu-Chen
Chang, Huang-Chih
Huang, Hung-Tu
Chen, Yu-Mu
Huang, Kuo-Tung
Chen, Kuan-Yi
Fang, Wen-Feng
Lin, Meng-Chih
Inhaled corticosteroids can reduce osteoporosis in female patients with COPD
title Inhaled corticosteroids can reduce osteoporosis in female patients with COPD
title_full Inhaled corticosteroids can reduce osteoporosis in female patients with COPD
title_fullStr Inhaled corticosteroids can reduce osteoporosis in female patients with COPD
title_full_unstemmed Inhaled corticosteroids can reduce osteoporosis in female patients with COPD
title_short Inhaled corticosteroids can reduce osteoporosis in female patients with COPD
title_sort inhaled corticosteroids can reduce osteoporosis in female patients with copd
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4951067/
https://www.ncbi.nlm.nih.gov/pubmed/27478374
http://dx.doi.org/10.2147/COPD.S106054
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