Cargando…

Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap

Background: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap (BCO) is a neglected area of trials, and it is not covered by guidelines for clinical practice. Methods: Using the National Health Insurance Research Database of Taiwan, COPD patients with or without bronchiectasis from...

Descripción completa

Detalles Bibliográficos
Autores principales: Su, Vincent Yi-Fong, Perng, Diahn-Warng, Chou, Ting-Chun, Chou, Yueh-Ching, Chang, Yuh-Lih, Hsu, Chia-Chen, Chou, Chia-Lin, Lee, Hsin-Chen, Chen, Tzeng-Ji, Hu, Po-Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306823/
https://www.ncbi.nlm.nih.gov/pubmed/30518165
http://dx.doi.org/10.3390/jcm7120517
_version_ 1783382865395843072
author Su, Vincent Yi-Fong
Perng, Diahn-Warng
Chou, Ting-Chun
Chou, Yueh-Ching
Chang, Yuh-Lih
Hsu, Chia-Chen
Chou, Chia-Lin
Lee, Hsin-Chen
Chen, Tzeng-Ji
Hu, Po-Wei
author_facet Su, Vincent Yi-Fong
Perng, Diahn-Warng
Chou, Ting-Chun
Chou, Yueh-Ching
Chang, Yuh-Lih
Hsu, Chia-Chen
Chou, Chia-Lin
Lee, Hsin-Chen
Chen, Tzeng-Ji
Hu, Po-Wei
author_sort Su, Vincent Yi-Fong
collection PubMed
description Background: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap (BCO) is a neglected area of trials, and it is not covered by guidelines for clinical practice. Methods: Using the National Health Insurance Research Database of Taiwan, COPD patients with or without bronchiectasis from 2000 to 2009 were enrolled as the BCO and COPD alone cohorts, respectively. Patients followed for <28 days, diagnosed with COPD who were not prescribed with COPD medications, and those diagnosed with bronchiectasis who did not receive a chest X-ray or computed tomography were excluded. The primary endpoints were acute exacerbations and mortality. Results: There were 831 patients in the BCO cohort and 3321 patients in the COPD alone cohort, covering 3763.08 and 17,348.95 person-years, respectively, from 2000 to 2011. The BCO cohort had higher risk for exacerbations (adjusted hazard ratio (HR) 2.26, 95% confidence interval (CI) 1.94–2.63) and mortality (HR 1.46, 95% CI 1.24–1.73) than the COPD alone cohort. In the patients overall, the use of statins, macrolides, and mucolytic agents was associated with significantly lower risks of acute exacerbations (statins, HR 0.37, 95% CI 0.29–0.46; macrolides, HR 0.65, 95% CI 0.45–0.93; mucolytic agents, HR 0.68, 95% CI 0.59–0.78). Statins were associated with a significantly lower risk of mortality (HR 0.32, 95% CI 0.25–0.41). In the BCO group, statins and mucolytic agents use was associated with significantly lower risks of acute exacerbations (statins, HR 0.44, 95% CI 0.29–0.65; mucolytic agents, HR 0.58, 95% CI 0.45–0.75). Conclusion: Statins and mucolytic agents use may lower risk of acute exacerbation in patients with BCO.
format Online
Article
Text
id pubmed-6306823
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-63068232019-01-02 Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap Su, Vincent Yi-Fong Perng, Diahn-Warng Chou, Ting-Chun Chou, Yueh-Ching Chang, Yuh-Lih Hsu, Chia-Chen Chou, Chia-Lin Lee, Hsin-Chen Chen, Tzeng-Ji Hu, Po-Wei J Clin Med Article Background: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap (BCO) is a neglected area of trials, and it is not covered by guidelines for clinical practice. Methods: Using the National Health Insurance Research Database of Taiwan, COPD patients with or without bronchiectasis from 2000 to 2009 were enrolled as the BCO and COPD alone cohorts, respectively. Patients followed for <28 days, diagnosed with COPD who were not prescribed with COPD medications, and those diagnosed with bronchiectasis who did not receive a chest X-ray or computed tomography were excluded. The primary endpoints were acute exacerbations and mortality. Results: There were 831 patients in the BCO cohort and 3321 patients in the COPD alone cohort, covering 3763.08 and 17,348.95 person-years, respectively, from 2000 to 2011. The BCO cohort had higher risk for exacerbations (adjusted hazard ratio (HR) 2.26, 95% confidence interval (CI) 1.94–2.63) and mortality (HR 1.46, 95% CI 1.24–1.73) than the COPD alone cohort. In the patients overall, the use of statins, macrolides, and mucolytic agents was associated with significantly lower risks of acute exacerbations (statins, HR 0.37, 95% CI 0.29–0.46; macrolides, HR 0.65, 95% CI 0.45–0.93; mucolytic agents, HR 0.68, 95% CI 0.59–0.78). Statins were associated with a significantly lower risk of mortality (HR 0.32, 95% CI 0.25–0.41). In the BCO group, statins and mucolytic agents use was associated with significantly lower risks of acute exacerbations (statins, HR 0.44, 95% CI 0.29–0.65; mucolytic agents, HR 0.58, 95% CI 0.45–0.75). Conclusion: Statins and mucolytic agents use may lower risk of acute exacerbation in patients with BCO. MDPI 2018-12-04 /pmc/articles/PMC6306823/ /pubmed/30518165 http://dx.doi.org/10.3390/jcm7120517 Text en © 2018 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Su, Vincent Yi-Fong
Perng, Diahn-Warng
Chou, Ting-Chun
Chou, Yueh-Ching
Chang, Yuh-Lih
Hsu, Chia-Chen
Chou, Chia-Lin
Lee, Hsin-Chen
Chen, Tzeng-Ji
Hu, Po-Wei
Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap
title Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap
title_full Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap
title_fullStr Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap
title_full_unstemmed Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap
title_short Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap
title_sort mucolytic agents and statins use is associated with a lower risk of acute exacerbations in patients with bronchiectasis-chronic obstructive pulmonary disease overlap
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306823/
https://www.ncbi.nlm.nih.gov/pubmed/30518165
http://dx.doi.org/10.3390/jcm7120517
work_keys_str_mv AT suvincentyifong mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT perngdiahnwarng mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT choutingchun mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT chouyuehching mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT changyuhlih mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT hsuchiachen mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT chouchialin mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT leehsinchen mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT chentzengji mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap
AT hupowei mucolyticagentsandstatinsuseisassociatedwithalowerriskofacuteexacerbationsinpatientswithbronchiectasischronicobstructivepulmonarydiseaseoverlap