Side Effects of Long-Term Inhaled Corticosteroid Use in Chronic Obstructive Pulmonary Disease

Abstract

Objectives: The literature lacks sufficient data on the long-term side effects of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) when used for over a year. In this study, the frequency of potential side effects was investigated in patients with COPD who had been using ICS. Methods: This single-center and observational study included stable COPD patients diagnosed with spirom- etry who had been using ICS for at least 1 year. Patient demographic and clinical characteristics and ICS-related side effects were recorded in detail according to the hospital records. Results: The study enrolled 92 patients, 74 (80.4%) of whom were male, with an mean age of 66.5± 8.4 years. The frequency of potential side effects of ICS, including voice changes, oral candidiasis, bruises, and cataracts, was higher after treatment than before treatment (3 [3.3%] vs. 34 [36.9%], p<0.001; 3 [3.3%] vs. 15 [16.0%], p=0.008; 2 [2.2%] vs. 14 [15.2%], p=0.004; and 9 [9.8%] vs. 25 [27.2%], p=0.009, respectively). However, there was no difference in the frequency of adverse events such as pneumonia, mycobacterial infection, osteoporo- sis, and diabetes mellitus before and after treatment (20 [21.7%] vs. 19 [20.7%], p=0.860; 8 [8.7%] vs. 2 [2.2%], p=0.109; 4 [4.3%] vs. 8 [8.7%], p=0.388; and 10 [10.9%] vs. 13 [14.1%], p=0.678, respectively). Conclusion: Recognizing and assessing the side effects of ICS in patients with COPD and evaluating decisions regarding the use of ICS in routine clinical practice based on the benefit-risk ratio may be necessary.