Use of high-dose inhaled corticosteroids is associated with pulmonary tuberculosis in patients with chronic obstructive pulmonary disease

Chin Chung Shu, Huey Dong Wu, Ming Chih Yu, Jann Tay Wang, Chih Hsin Lee, Hao Chien Wang, Jann Yuan Wang, Li Na Lee, Chong Jen Yu, Pan Chyr Yang

研究成果: 雜誌貢獻文章

28 引文 斯高帕斯(Scopus)

摘要

The use of high-dose inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) has recently been shown to increase the incidence of pneumonia. However, to our knowledge, the impact of high-dose ICS on pulmonary tuberculosis (TB) has never been investigated. To study that impact, we conducted a retrospective study including patients aged more than 40 years old with irreversible airflow limitation between August 2000 and July 2008 in a medical center in Taiwan.Of the 36,684 patients who underwent pulmonary function testing, we included 554 patients. Among them, patients using high-dose ICS (equivalent to >500 μg/d of fluticasone) were more likely to have more severe COPD and receive oral corticosteroids than those using medium-dose, low-dose, or no ICS. Sixteen (3%) patients developed active pulmonary TB within a follow-up of 25,544 person-months. Multivariate Cox regression analysis revealed that the use of high-dose ICS, the use of 10 mg or more of prednisolone per day, and prior pulmonary TB were independent risk factors for the development of active pulmonary TB. Chest radiography and sputum smear/culture for Mycobacterium tuberculosis should be performed before initiating high-dose ICS and regularly thereafter.

原文英語
頁(從 - 到)53-61
頁數9
期刊Medicine (United States)
89
發行號1
DOIs
出版狀態已發佈 - 一月 2010

    指紋

ASJC Scopus subject areas

  • Medicine(all)

引用此