노인 중증 천식에서 장기 경구스테로이드 사용으로 인한 감염 발생 위험 연구
Long-Term Oral Corticosteroid Use and Related Infections in Elderly Patients with Severe Asthma
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Objectives: To evaluate the risk of infections by long-term oral corticosteroid use in elderly patients with severe asthma. Methods: This is a retrospective cohort study using nationally representative data, namely Health Insurance Review and Assessment Service-Aged Patient Sample 2015, that included medical and pharmacy claims of approximately 1 million elderly patients aged 65 or older. We included severe asthma patients who were classified as step 5 of Global Initiative for Asthma (GINA) guideline. Multivariate logistic regression was performed to compare incidence of infection in severe asthma patients continuously exposed ≥3 months oral corticosteroids (OCS) with severe asthma patients who continuously exposed ≥3 months tiotropium. Results: A total of 45 patients in OCS group and 107 patients in tiotropium group were identified. The odds of developing associated any infections were slightly higher but not significant in OCS group compared to those in tiotropium group; odds ratio (OR)=1.50, 95% confidence interval (CI)=0.67−3.36. In sub-group analysis, the odds of developing pneumonia were slightly lower (OR=0.78, 95% CI=0.30−2.00) and developing fungal infection were higher (OR=2.30, 95% CI=0.89−6.00) in OCS group compared to tiotropium group but both were not significant. Conclusion: Infections are known as oral corticosteroid related complication. However, the results of relationship between OCS use and incidence of infection were not significant. Further studies are warranted to evaluate the incidence of oral corticosteroids related infection
Abstract
Objectives: To evaluate the risk of infections by long-term oral corticosteroid use in elderly patients with severe asthma. Methods: This is a retrospective cohort study using nationally representative data, namely Health Insurance Review and Assessment Service-Aged Patient Sample 2015, that included medical and pharmacy claims of approximately 1 million elderly patients aged 65 or older. We included severe asthma patients who were classified as step 5 of Global Initiative for Asthma (GINA) guideline. Multivariate logistic regression was performed to compare incidence of infection in severe asthma patients continuously exposed ≥3 months oral corticosteroids (OCS) with severe asthma patients who continuously exposed ≥3 months tiotropium. Results: A total of 45 patients in OCS group and 107 patients in tiotropium group were identified. The odds of developing associated any infections were slightly higher but not significant in OCS group compared to those in tiotropium group; odds ratio (OR)=1.50, 95% confidence interval (CI)=0.67−3.36. In sub-group analysis, the odds of developing pneumonia were slightly lower (OR=0.78, 95% CI=0.30−2.00) and developing fungal infection were higher (OR=2.30, 95% CI=0.89−6.00) in OCS group compared to tiotropium group but both were not significant. Conclusion: Infections are known as oral corticosteroid related complication. However, the results of relationship between OCS use and incidence of infection were not significant. Further studies are warranted to evaluate the incidence of oral corticosteroids related infection
참고문헌 (8)
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