Most Read Articles
Jairia Dela Cruz, 3 days ago
Metabolic and bariatric surgery (MBS) leads to large and sustained reductions in, and even reversal of, multiple risk factors for future joint disease in adolescents with severe obesity and musculoskeletal pain, according to data from the Teen Longitudinal Assessment of Bariatric Surgery study.
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Pearl Toh, 6 days ago
Obeticholic acid significantly improves fibrosis and disease activity in patients with nonalcoholic steatohepatitis (NASH), a chronic liver disease currently with no approved therapy, according to an interim analysis of the landmark REGENERATE* study.

Long-term inhaled corticosteroid therapy for COPD may have serious adverse effects

06 Dec 2019

Exposure to inhaled corticosteroid (ICS) therapy for chronic obstructive pulmonary disease (COPD) in the long term may be detrimental to patients, being associated with elevated risks of diabetes, its progression and osteoporosis, as shown in a study.

The study used data from two large UK databases of patients (age ≥40 years) initiating ICS or long-acting bronchodilator (LABD) for COPD. Treatment was assessed in relation to the risk of diabetes onset (n=17,970), diabetes progression (n=804) or osteoporosis incidence (n=19,898).

All patients had available ≥1-year baseline and ≥2-year outcome data, with a median follow-up of 3.7–5.6 years per treatment group.

Conditional proportional hazards regression revealed that compared with LABD, ICS was associated with an increased risk of diabetes onset (adjusted hazard ratio [HR], 1.27, 95 percent confidence interval [CI], 1.07-1.50). There was no overall risk increase observed for diabetes progression (adjusted HR, 1.04, 95 percent CI, 0.87–1.25) and incident osteoporosis (adjusted HR, 1.13, 95 percent CI, 0.93–1.39).

However, a dose-response relationship for all three outcomes became apparent at mean ICS exposures of 500 µg/day (vs <250 µg/day, fluticasone propionate-equivalent). This pattern of association was not evident for cumulative ICS exposures.

The present data raise uncertainty with regard to the risk-benefit ratio for ICS in COPD. Hence, researchers stressed that careful selection of COPD therapies be practiced and that clinicians prescribe ICS only when indicated (within current GOLD strategy recommendations) and at the lowest possible doses.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Jairia Dela Cruz, 3 days ago
Metabolic and bariatric surgery (MBS) leads to large and sustained reductions in, and even reversal of, multiple risk factors for future joint disease in adolescents with severe obesity and musculoskeletal pain, according to data from the Teen Longitudinal Assessment of Bariatric Surgery study.
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Pearl Toh, 6 days ago
Obeticholic acid significantly improves fibrosis and disease activity in patients with nonalcoholic steatohepatitis (NASH), a chronic liver disease currently with no approved therapy, according to an interim analysis of the landmark REGENERATE* study.