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- Publisher Website: 10.2147/COPD.S433326
- Scopus: eid_2-s2.0-85177181573
- PMID: 38022830
- WOS: WOS:001106650400001
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Article: A Long-Term Study of Adverse Outcomes Associated With Oral Corticosteroid Use in COPD
Title | A Long-Term Study of Adverse Outcomes Associated With Oral Corticosteroid Use in COPD |
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Authors | |
Keywords | chronic obstructive pulmonary disease cohort study COPD corticosteroids observational primary care |
Issue Date | 2023 |
Citation | International Journal of COPD, 2023, v. 18, p. 2565-2580 How to Cite? |
Abstract | Background: Oral corticosteroids (OCS) are often prescribed for chronic obstructive pulmonary disease (COPD) exacerbations. Methods: This observational, individually matched historical cohort study used electronic medical records (1987–2019) from the UK Clinical Practice Research Datalink linked to English Hospital Episode Statistics (HES) to evaluate adverse outcomes in patients with COPD who used OCS (OCS cohort) and those not exposed to OCS (non-OCS cohort). Risk of 17 adverse outcomes was estimated using proportional hazard regression. Results: Of 323,722 patients, 106,775 (33.0%) had COPD-related OCS prescriptions. Of the 106,775 patients in the overall cohort, 58,955 had HES linkage and were eligible for inclusion in the OCS cohort. The individual matching process identified 53,299 pairs of patients to form the OCS and non-OCS cohorts. Median follow-up post-index was 6.9 years (OCS cohort) and 5.4 years (non-OCS cohort). Adjusted risk of multiple adverse outcomes was higher for the OCS cohort versus the non-OCS cohort, including osteoporosis with/without fractures (adjusted hazard ratio [aHR] 1.80; 95% confidence interval [CI] 1.70–1.92), type 2 diabetes mellitus (aHR 1.44; 95% CI 1.37–1.51), cardiovascular/cerebro-vascular disease (aHR 1.26; 95% CI 1.21–1.30), and all-cause mortality (aHR 1.04; 95% CI 1.02–1.07). In the OCS cohort, risk of most adverse outcomes increased with increasing categorized cumulative OCS dose. For example, risk of cardiovascular/cerebrovascular disease was 34% higher in the 1.0–<2.5 g group versus the <0.5 g group (HR 1.34; 95% CI 1.26–1.42). Conclusion: Any OCS use was associated with higher risk of adverse outcomes in patients with COPD, with risk generally increasing with greater cumulative OCS dose. |
Persistent Identifier | http://hdl.handle.net/10722/336957 |
ISSN | 2013 Impact Factor: 2.732 2023 SCImago Journal Rankings: 0.954 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Tse, Gary | - |
dc.contributor.author | Emmanuel, Benjamin | - |
dc.contributor.author | Ariti, Cono | - |
dc.contributor.author | Bafadhel, Mona | - |
dc.contributor.author | Papi, Alberto | - |
dc.contributor.author | Carter, Victoria | - |
dc.contributor.author | Zhou, Jiandong | - |
dc.contributor.author | Skinner, Derek | - |
dc.contributor.author | Xu, Xiao | - |
dc.contributor.author | Müllerová, Hana | - |
dc.contributor.author | Price, David | - |
dc.date.accessioned | 2024-02-29T06:57:42Z | - |
dc.date.available | 2024-02-29T06:57:42Z | - |
dc.date.issued | 2023 | - |
dc.identifier.citation | International Journal of COPD, 2023, v. 18, p. 2565-2580 | - |
dc.identifier.issn | 1176-9106 | - |
dc.identifier.uri | http://hdl.handle.net/10722/336957 | - |
dc.description.abstract | Background: Oral corticosteroids (OCS) are often prescribed for chronic obstructive pulmonary disease (COPD) exacerbations. Methods: This observational, individually matched historical cohort study used electronic medical records (1987–2019) from the UK Clinical Practice Research Datalink linked to English Hospital Episode Statistics (HES) to evaluate adverse outcomes in patients with COPD who used OCS (OCS cohort) and those not exposed to OCS (non-OCS cohort). Risk of 17 adverse outcomes was estimated using proportional hazard regression. Results: Of 323,722 patients, 106,775 (33.0%) had COPD-related OCS prescriptions. Of the 106,775 patients in the overall cohort, 58,955 had HES linkage and were eligible for inclusion in the OCS cohort. The individual matching process identified 53,299 pairs of patients to form the OCS and non-OCS cohorts. Median follow-up post-index was 6.9 years (OCS cohort) and 5.4 years (non-OCS cohort). Adjusted risk of multiple adverse outcomes was higher for the OCS cohort versus the non-OCS cohort, including osteoporosis with/without fractures (adjusted hazard ratio [aHR] 1.80; 95% confidence interval [CI] 1.70–1.92), type 2 diabetes mellitus (aHR 1.44; 95% CI 1.37–1.51), cardiovascular/cerebro-vascular disease (aHR 1.26; 95% CI 1.21–1.30), and all-cause mortality (aHR 1.04; 95% CI 1.02–1.07). In the OCS cohort, risk of most adverse outcomes increased with increasing categorized cumulative OCS dose. For example, risk of cardiovascular/cerebrovascular disease was 34% higher in the 1.0–<2.5 g group versus the <0.5 g group (HR 1.34; 95% CI 1.26–1.42). Conclusion: Any OCS use was associated with higher risk of adverse outcomes in patients with COPD, with risk generally increasing with greater cumulative OCS dose. | - |
dc.language | eng | - |
dc.relation.ispartof | International Journal of COPD | - |
dc.subject | chronic obstructive pulmonary disease | - |
dc.subject | cohort study | - |
dc.subject | COPD | - |
dc.subject | corticosteroids | - |
dc.subject | observational | - |
dc.subject | primary care | - |
dc.title | A Long-Term Study of Adverse Outcomes Associated With Oral Corticosteroid Use in COPD | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.2147/COPD.S433326 | - |
dc.identifier.pmid | 38022830 | - |
dc.identifier.scopus | eid_2-s2.0-85177181573 | - |
dc.identifier.volume | 18 | - |
dc.identifier.spage | 2565 | - |
dc.identifier.epage | 2580 | - |
dc.identifier.eissn | 1178-2005 | - |
dc.identifier.isi | WOS:001106650400001 | - |