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Long-term use of inhaled corticosteroids and risk of upper respiratory tract infection in chronic obstructive pulmonary disease: a meta-analysis.
Inhal Toxicol. 2017 04; 29(5):219-226.IT

Abstract

Recent studies have suggested that inhaled corticosteroids (ICS) may be associated with higher risks of tuberculosis and pneumonia in patients with COPD. However, it is not known whether ICS increases the risk of upper respiratory tract infection (URTI). Aim of this study was to explore the relationship between ICS and URTI. Through a comprehensive literature search of PubMed, EMBASE, Cochrane Library, and Google Scholar from inception to March 2016, we identified randomized controlled trials of ICS therapy lasting at least 6 months. A meta-analysis by the Peto approach was also conducted to generate summary estimates comparing ICS with non-ICS treatment on the risk of URTI. A total of 14 studies involving 19,777 subjects were considered in the meta-analysis. Compared with non-ICS treatment, ICS were associated with a significantly increased risk of URTI (Peto OR: 1.16; 95% CI: 1.05-1.29; I2 = 9%; p = .004). Subgroup analyzes were performed for different dose, high-dose ICS was associated with a significantly increased risk of URTI (Peto OR: 1.19; 95% CI: 1.05-1.34; I2 = 0%; p = .005), whereas low-dose ICS showed a non-significant increased risk of URTI (Peto OR: 1.10; 95% CI: 0.91-1.33; I2 = 0%; p = .32). Moreover, fluticasone was observed with an increased risk of URTI but not mometasone; high-dose fluticasone treatment was associated with a significantly higher risk of URTI but not low-dose. These results suggested to us that ICS use may increase the risk of URTI in patients with COPD, but it should be further investigated.

Authors+Show Affiliations

a Respiratory Diseases Laboratory , Chengdu Second People's Hospital , Chengdu , China.a Respiratory Diseases Laboratory , Chengdu Second People's Hospital , Chengdu , China.b Digestive System Department , Chengdu Second People's Hospital , Chengdu , China.a Respiratory Diseases Laboratory , Chengdu Second People's Hospital , Chengdu , China.a Respiratory Diseases Laboratory , Chengdu Second People's Hospital , Chengdu , China.a Respiratory Diseases Laboratory , Chengdu Second People's Hospital , Chengdu , China.a Respiratory Diseases Laboratory , Chengdu Second People's Hospital , Chengdu , China.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28714745

Citation

Yang, Mingjin, et al. "Long-term Use of Inhaled Corticosteroids and Risk of Upper Respiratory Tract Infection in Chronic Obstructive Pulmonary Disease: a Meta-analysis." Inhalation Toxicology, vol. 29, no. 5, 2017, pp. 219-226.
Yang M, Chen H, Zhang Y, et al. Long-term use of inhaled corticosteroids and risk of upper respiratory tract infection in chronic obstructive pulmonary disease: a meta-analysis. Inhal Toxicol. 2017;29(5):219-226.
Yang, M., Chen, H., Zhang, Y., Du, Y., Xu, Y., Jiang, P., & Xu, Z. (2017). Long-term use of inhaled corticosteroids and risk of upper respiratory tract infection in chronic obstructive pulmonary disease: a meta-analysis. Inhalation Toxicology, 29(5), 219-226. https://doi.org/10.1080/08958378.2017.1346006
Yang M, et al. Long-term Use of Inhaled Corticosteroids and Risk of Upper Respiratory Tract Infection in Chronic Obstructive Pulmonary Disease: a Meta-analysis. Inhal Toxicol. 2017;29(5):219-226. PubMed PMID: 28714745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term use of inhaled corticosteroids and risk of upper respiratory tract infection in chronic obstructive pulmonary disease: a meta-analysis. AU - Yang,Mingjin, AU - Chen,Hong, AU - Zhang,Yan, AU - Du,Yuejun, AU - Xu,Ying, AU - Jiang,Ping, AU - Xu,Zhibo, Y1 - 2017/07/17/ PY - 2017/7/18/pubmed PY - 2018/4/10/medline PY - 2017/7/18/entrez KW - Inhaled corticosteroids (ICS) KW - chronic obstructive pulmonary disease (COPD) KW - meta-analysis KW - risk KW - upper respiratory tract infection (URTI) SP - 219 EP - 226 JF - Inhalation toxicology JO - Inhal Toxicol VL - 29 IS - 5 N2 - Recent studies have suggested that inhaled corticosteroids (ICS) may be associated with higher risks of tuberculosis and pneumonia in patients with COPD. However, it is not known whether ICS increases the risk of upper respiratory tract infection (URTI). Aim of this study was to explore the relationship between ICS and URTI. Through a comprehensive literature search of PubMed, EMBASE, Cochrane Library, and Google Scholar from inception to March 2016, we identified randomized controlled trials of ICS therapy lasting at least 6 months. A meta-analysis by the Peto approach was also conducted to generate summary estimates comparing ICS with non-ICS treatment on the risk of URTI. A total of 14 studies involving 19,777 subjects were considered in the meta-analysis. Compared with non-ICS treatment, ICS were associated with a significantly increased risk of URTI (Peto OR: 1.16; 95% CI: 1.05-1.29; I2 = 9%; p = .004). Subgroup analyzes were performed for different dose, high-dose ICS was associated with a significantly increased risk of URTI (Peto OR: 1.19; 95% CI: 1.05-1.34; I2 = 0%; p = .005), whereas low-dose ICS showed a non-significant increased risk of URTI (Peto OR: 1.10; 95% CI: 0.91-1.33; I2 = 0%; p = .32). Moreover, fluticasone was observed with an increased risk of URTI but not mometasone; high-dose fluticasone treatment was associated with a significantly higher risk of URTI but not low-dose. These results suggested to us that ICS use may increase the risk of URTI in patients with COPD, but it should be further investigated. SN - 1091-7691 UR - https://www.unboundmedicine.com/medline/citation/28714745/Long_term_use_of_inhaled_corticosteroids_and_risk_of_upper_respiratory_tract_infection_in_chronic_obstructive_pulmonary_disease:_a_meta_analysis_ L2 - https://www.tandfonline.com/doi/full/10.1080/08958378.2017.1346006 DB - PRIME DP - Unbound Medicine ER -