Ann Fam Med
Long-term inhaled corticosteroid use linked to adverse outcomes in COPD
April 1, 2025

Study details: Researchers analyzed electronic health record data from individuals aged >45 years with COPD. The study included 318,385 individuals in the prevalent cohort and 209,062 in the inception cohort. The prevalent cohort required a diagnosis of COPD any time during the observation period, while the inception cohort required a diagnosis of COPD made after entry into the database. The primary focus was on comparing long-term (>24 months) vs. short-term (<4 months) inhaled corticosteroid (ICS) exposure.
Results: Long-term ICS use was associated with significantly higher rates of adverse outcomes, including T2DM, cataracts, pneumonia, osteoporosis, and nontraumatic fractures. Hazard ratios for the composite outcome were 2.65 (95% confidence interval [CI], 2.62-2.68; P <.001) for the prevalent cohort and 2.60 (95% CI, 2.56-2.64; P <.001) for the inception cohort. Additionally, recurrent pneumonia and fractures were notably increased in both cohorts.
Clinical impact: The findings highlight the need for cautious use of long-term ICS in COPD management. Physicians should weigh the benefits against potential risks and consider alternative therapies to minimize adverse outcomes in COPD patients.
Source:
Pace WD, et al. (2025, March 23). Ann Fam Med. Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease. https://pubmed.ncbi.nlm.nih.gov/40127974/
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