Status and compliance with the guideline of inhaled corticosteroids use in patients with chronic obstructive pulmonary disease
10.3760/cma.j.cn431274-20220619-00580
- VernacularTitle:慢性阻塞性肺疾病患者吸入性糖皮质激素使用现状及指南依从性
- Author:
Chujuan TANG
1
;
Jing LI
;
Dingding DENG
;
Yi LIU
;
Yan CHEN
;
Shan CAI
;
Ping CHEN
Author Information
1. 中南大学湘雅二医院呼吸与危重症医学科 中南大学呼吸疾病研究所，长沙 410011
- Keywords:
Pulmonary disease, chronic obstructive;
Glucocorticoid;
Administration, inhalation
- From:
Journal of Chinese Physician
2022;24(7):970-975
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) in the real world and analyze its compliance with the guidelines.Methods:This study is a multicenter, cross-sectional study. 1 051 COPD patients who were treated in the Second Xiangya Hospital of Central South University, the First Affiliated Hospital of Shaoyang College and Zhuzhou Central Hospital from January 2020 to March 2022 were collected. The general information, drug use, types of exposure risk factors, acute exacerbation (AE) in the past year, the scores of the modified British Medical Research Council Dyspnea Questionnaire (mMRC), COPD Assessment Test (CAT), pulmonary function, blood routine of patients were collected. The status of ICS use in COPD patients, the clinical characteristics and guideline compliance of non-ICS users and ICS users were analyzed.Results:Among 1 051 patients with COPD, ICS was used in 490 cases (46.6%) and was not used in 561 cases (53.4%). ICS use was associated with relapse, frequent AE, severe AE, Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) grade 2 or above, GOLD D group, mMRC score, bronchial asthma, and blood eosinophils (EOS) (all P<0.05). Among 1 051 patients, 583(55.5%) were newly treated, 222(38.1%) were newly treated with ICS, and 361(61.9%) were not treated with ICS. ICS use in newly treated patients was associated with frequent AE, severe AE in the past year, GOLD grade 2 to 3, GOLD B and D group, mMRC score, bronchial asthma, and blood EOS (all P<0.05). Conclusions:Nearly half of patients with COPD are treated with ICS, and patients with ICS use had a higher risk of AE, more severe symptoms, higher blood EOS, and higher rates of asthma. However, there still exists the phenomenon of overuse of ICS.
