anatol j fm. 2024; 7(3): 115-120 | DOI: 10.5505/ajfamed.2024.43531

Side Effects of Long-Term Inhaled Corticosteroid Use in Chronic Obstructive Pulmonary Disease

Fatma Ceren Gürel¹, Deniz Bilici², Esra Ertan Yazar², Burcu Arpinar Yigitbas², Coþkun Doðan², Hacer Hicran Mutlu¹, Mehmet Sargýn^1
1Department of Family Medicine, Istanbul Medeniyet University, Faculty of Medicine, Ýstanbul, Türkiye
²Department of Chest Diseases, Istanbul Medeniyet University, Faculty of Medicine, Ýstanbul, Türkiye

INTRODUCTION: The literature lacks sufficient data on the long-term side effects of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) when used for over a year. In this study, the frequency of potential side effects was investigated in patients with COPD who had been using ICS.
METHODS: This single-center and observational study included stable COPD patients diagnosed with spirom-etry who had been using ICS for at least 1 year. Patient demographic and clinical characteristics and ICS-related side effects were recorded in detail according to the hospital records.
RESULTS: The study enrolled 92 patients, 74 (80.4%) of whom were male, with an mean age of 66.5±8.4 years. The frequency of potential side effects of ICS, including voice changes, oral candidiasis, bruises, and cataracts, was higher after treatment than before treatment (3 [3.3%] vs. 34 [36.9%], p<0.001; 3 [3.3%] vs. 15 [16.0%], p=0.008; 2 [2.2%] vs. 14 [15.2%], p=0.004; and 9 [9.8%] vs. 25 [27.2%], p=0.009, respectively). However, there was no difference in the frequency of adverse events such as pneumonia, mycobacterial infection, osteoporo-sis, and diabetes mellitus before and after treatment (20 [21.7%] vs. 19 [20.7%], p=0.860; 8 [8.7%] vs. 2 [2.2%], p=0.109; 4 [4.3%] vs. 8 [8.7%], p=0.388; and 10 [10.9%] vs. 13 [14.1%], p=0.678, respectively).
DISCUSSION AND CONCLUSION: Recognizing and assessing the side effects of ICS in patients with COPD and evaluating decisions regarding the use of ICS in routine clinical practice based on the benefit-risk ratio may be necessary.

Keywords: Adverse effects, cataract, chronic obstructive pulmonary disease, oral candidiasis, pneumonia

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