Abstract
Study Objective. To determine whether patients prescribed inhaled corticosteroids are at risk for adverse gastrointestinal effects. Design. Retrospective cohort study. Setting. Urban health center with an academic affiliation. Patients. A total of 19,443 adults (mean age 31.8 yrs) with airways disease, defined as a diagnosis of asthma or chronic obstructive pulmonary disease, and who were prescribed both an inhaled corticosteroid and albuterol (7156 patients) or inhaled albuterol alone (12,287 patients) between November 1977 and February 2002. Measurements and Main Results. The frequency of adverse gastrointestinal events in the patients who used inhaled corticosteroids and albuterol was compared with that in the patients who used albuterol alone. Adverse gastrointestinal outcomes included events such as gastritis, ulcers, and bleeding. Cox proportional hazards models were used to determine the risk of adverse events, controlling for possible confounders such as alcohol use or nonsteroidal antiinflammatory drug use. Adverse gastrointestinal events were observed in 461 (6.4%) patients using inhaled corticosteroids and albuterol and in 302 (2.5%) patients using only albuterol. After controlling for potential confounders, patients who used inhaled corticosteroids and albuterol had an increased risk for adverse gastrointestinal events compared with patients who used only inhaled albuterol (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.02-1.56). A prescription for a spacer device reduced this risk among patients using an inhaled corticosteroid (HR 0.26, 95% CI 0.20-0.34). Conclusion. Patients using inhaled corticosteroids appear to have a slight risk for adverse gastrointestinal events that is mitigated in patients who used a spacer device.
| Original language | English |
|---|---|
| Pages (from-to) | 1325-1334 |
| Number of pages | 10 |
| Journal | Pharmacotherapy |
| Volume | 28 |
| Issue number | 11 PART 1 |
| DOIs | |
| State | Published - Nov 2008 |
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Keywords
- Asthma
- Gastrointestinal adverse events
- Inhaled corticosteroids
- Obstructive airways disease
- Spacer
ASJC Scopus subject areas
- Pharmacology (medical)
Cite this
Risk of adverse gastrointestinal events from inhaled corticosteroids. / Hansen, Richard A.; Tu, Wanzhu; Wang, Jane; Ambuehl, Roberta; McDonald, Clement J.; Murray, Michael.
In: Pharmacotherapy, Vol. 28, No. 11 PART 1, 11.2008, p. 1325-1334.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk of adverse gastrointestinal events from inhaled corticosteroids
AU - Hansen, Richard A.
AU - Tu, Wanzhu
AU - Wang, Jane
AU - Ambuehl, Roberta
AU - McDonald, Clement J.
AU - Murray, Michael
PY - 2008/11
Y1 - 2008/11
N2 - Study Objective. To determine whether patients prescribed inhaled corticosteroids are at risk for adverse gastrointestinal effects. Design. Retrospective cohort study. Setting. Urban health center with an academic affiliation. Patients. A total of 19,443 adults (mean age 31.8 yrs) with airways disease, defined as a diagnosis of asthma or chronic obstructive pulmonary disease, and who were prescribed both an inhaled corticosteroid and albuterol (7156 patients) or inhaled albuterol alone (12,287 patients) between November 1977 and February 2002. Measurements and Main Results. The frequency of adverse gastrointestinal events in the patients who used inhaled corticosteroids and albuterol was compared with that in the patients who used albuterol alone. Adverse gastrointestinal outcomes included events such as gastritis, ulcers, and bleeding. Cox proportional hazards models were used to determine the risk of adverse events, controlling for possible confounders such as alcohol use or nonsteroidal antiinflammatory drug use. Adverse gastrointestinal events were observed in 461 (6.4%) patients using inhaled corticosteroids and albuterol and in 302 (2.5%) patients using only albuterol. After controlling for potential confounders, patients who used inhaled corticosteroids and albuterol had an increased risk for adverse gastrointestinal events compared with patients who used only inhaled albuterol (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.02-1.56). A prescription for a spacer device reduced this risk among patients using an inhaled corticosteroid (HR 0.26, 95% CI 0.20-0.34). Conclusion. Patients using inhaled corticosteroids appear to have a slight risk for adverse gastrointestinal events that is mitigated in patients who used a spacer device.
AB - Study Objective. To determine whether patients prescribed inhaled corticosteroids are at risk for adverse gastrointestinal effects. Design. Retrospective cohort study. Setting. Urban health center with an academic affiliation. Patients. A total of 19,443 adults (mean age 31.8 yrs) with airways disease, defined as a diagnosis of asthma or chronic obstructive pulmonary disease, and who were prescribed both an inhaled corticosteroid and albuterol (7156 patients) or inhaled albuterol alone (12,287 patients) between November 1977 and February 2002. Measurements and Main Results. The frequency of adverse gastrointestinal events in the patients who used inhaled corticosteroids and albuterol was compared with that in the patients who used albuterol alone. Adverse gastrointestinal outcomes included events such as gastritis, ulcers, and bleeding. Cox proportional hazards models were used to determine the risk of adverse events, controlling for possible confounders such as alcohol use or nonsteroidal antiinflammatory drug use. Adverse gastrointestinal events were observed in 461 (6.4%) patients using inhaled corticosteroids and albuterol and in 302 (2.5%) patients using only albuterol. After controlling for potential confounders, patients who used inhaled corticosteroids and albuterol had an increased risk for adverse gastrointestinal events compared with patients who used only inhaled albuterol (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.02-1.56). A prescription for a spacer device reduced this risk among patients using an inhaled corticosteroid (HR 0.26, 95% CI 0.20-0.34). Conclusion. Patients using inhaled corticosteroids appear to have a slight risk for adverse gastrointestinal events that is mitigated in patients who used a spacer device.
KW - Asthma
KW - Gastrointestinal adverse events
KW - Inhaled corticosteroids
KW - Obstructive airways disease
KW - Spacer
UR - http://www.scopus.com/inward/record.url?scp=55549090341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=55549090341&partnerID=8YFLogxK
U2 - 10.1592/phco.28.11.1325
DO - 10.1592/phco.28.11.1325
M3 - Article
C2 - 18956992
AN - SCOPUS:55549090341
VL - 28
SP - 1325
EP - 1334
JO - Pharmacotherapy
JF - Pharmacotherapy
SN - 0277-0008
IS - 11 PART 1
ER -