Eur Respir J:COPD患者使用ICS与骨质疏松和骨折风险的关系

2020-09-28 MedSci原创 MedSci原创

COPD患者发生骨折和骨质疏松症的风险更大,使用大剂量ICS会进一步增加这种风险。

慢性阻塞性肺疾病(COPD)患者吸入糖皮质激素(ICS)治疗对骨质疏松和骨折风险的影响尚未明确。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,这项研究旨在评估COPD患者的风险。

2000年至2014年间,研究人员从52个瑞典初级保健中心收集了COPD患者和相匹配的参考对照者的电子病历数据。该研究分析的结局是ICS对所有骨折的影响。骨折通常指与骨质疏松症相关的骨折、骨质疏松症诊断记录、骨质疏松症的药物处方以及与任何骨质疏松症相关事件的综合指标。根据ICS暴露水平对COPD患者进行分层。

该研究总共分析了9651例COPD患者和59454例匹配的对照者。在随访期间,19.9%的COPD患者至少有1次骨质疏松相关事件,而对照组为12.9%(p<0.0001)。COPD人群的多变量分析发现存在剂量-效应关系,大剂量ICS与任何骨质疏松相关事件均显著相关(风险比[RR;95%置信区间]为1.52[1.24–1.62]),而相应的估计值与未使用ICS的COPD患者相比,低剂量ICS的患者为1.27(1.13-1.56)。在所有四种特定的与骨质疏松症相关的事件中都发现了类似的剂量相关不良反应。

由此可见,COPD患者发生骨折和骨质疏松症的风险更大,使用大剂量ICS会进一步增加这种风险。

原始出处:

Christer Janson,et al.Osteoporosis and fracture risk associated with ICS use among Swedish COPD patients: the ARCTIC study.Eur Respir J.2020.https://erj.ersjournals.com/content/early/2020/08/28/13993003.00515-2020

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    2020-12-31 大叔默默路过

    不错

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    2020-09-29 gous
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    2020-09-29 Eleven17
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    2020-09-28 ms5000000680145189

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