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[Outcomes research for complications of inhaled bronchodilators/corticosteroids] |
Lee CH, Jang EJ, Yim JJ, Yoon H, Kim DK, Kim YJ, Kim J, Choi SM |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Lee CH, Jang EJ, Yim JJ, Yoon H, Kim DK, Kim YJ, Kim J, Choi SM. [Outcomes research for complications of inhaled bronchodilators/corticosteroids] Seoul: National Evidence-based Healthcare Collaborating Agency (NECA). NECA-A-13-004. 2013 Authors' conclusions In ICS users, the risk of pneumonia was higher in MDI compared with DPI after adjustment for age, gender, respiratory disease, comorbidities, health care utilization, and concomitant medications (HR 1.6; 95% CI 1.2 to 2). Additionally, in ICS/LABA users, the risk of pneumonia was higher in MDI compared with DPI, after adjustment for age, gender, respiratory disease, comorbidities, health care utilization, and concomitant medications (HR 1.6; 95% CI 1.3 to 1.9).
SABA was associated with a higher risk of hemoptysis (OR 1.2; 95% CI 1.2 to 1.4) after adjustment for other inhaler medication and age, Charlson comorbidity index (CCI), comorbidities, health care utilization, and concomitant medications. This association was observed in LAMA (OR 1.2; 95% CI 1.1 to 1.4) and SAMA (OR 1.6; 95% CI 1.1 to 2.4).
After adjusting for concomitant medications, baseline characteristics, health care utilization, and medication history, the risk of PIH was lower for 0~15,000 mg ICS cumulative dose compared with non-users (OR 0.8; 95% CI 0.64 to 0.99). In contrast, the risk of PIH was higher in those receiving >15,000 mg compared with non-user (OR 1.3; 95% CI 1.01 to 1.79).
SABA was associated with a higher risk of acute myocardial infarction (OR 1.2; 95% CI 1.1 to 1.3), after adjustment for other inhaler medication and age, CCI, comorbidities, health care utilization, and concomitant medications. This association was observed in LABA (OR 1.3; 95% CI 1.1 to 1.6).
After adjusting for other inhaler medication and age, CCI, comorbidities, health care utilization, and concomitant medications, the risk of tachyarrhythmia was higher in ICS with LABA users compared with non-users (OR 1.2; 95% CI 1.0 to 1.3). This association was observed in LABA (OR 1.3; 95% CI 1.1 to 1.5).
We suggest that the use of MDI device may increase the risk of hospital admission or emergency room visit for pneumonia than DPI device when ICS or ICS/LABA is used. SABA, LAMA, and SAMA may increase the risk of hemoptysis in bronchiectasis patients. As MPR or cumulative dose of ICS is higher, the risk of the PIH in pregnant women is higher. SABA, LABA or LABA alone may increase the risk of AMI and ICS/LABA or LAMA is associated with an increased risk of tachyarrhythmia.
Indexing Status Subject indexing assigned by CRD MeSH Administration, Inhalation; Adrenal Cortex Hormones; Bronchodilator Agents; Drug-Related Side Effects and Adverse Reactions; Humans Country of organisation South Korea English summary An English language summary is available. Address for correspondence National Evidence-based Healthcare Collaborating Agency (NECA), Changkyung B/D 9F, Wonnam-dong 28-7, Jongno-gu, Seoul, South Korea
Email: hta_neca@neca.re.kr AccessionNumber 32014001092 Date abstract record published 25/09/2014 |
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