Chronic respiratory disease, inhaled corticosteroids and risk of non-tuberculous mycobacteriosis
Claire Andrejak,Rikke Beck Nielsen,Vibeke Østergaard Thomsen,Pierre Duhaut,Henrik Toft Sørensen,Reimar W. Thomsen +5 more
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TLDR
Chronic respiratory disease, particularly COPD treated with ICS therapy, is a strong risk factor for non-tuberculous mycobacterial pulmonary disease.Abstract:
Background Chronic respiratory disease and inhaled corticosteroid (ICS) therapy for chronic obstructive pulmonary disease (COPD) increase the risk of pneumonia. Few data are available on the association of these risk factors with non-tuberculous mycobacterial (NTM) pulmonary disease. Methods This study examined chronic respiratory diseases and ICS use as risk factors in a population-based case-control study encompassing all adults in Denmark with microbiologically confirmed NTM pulmonary disease between 1997 and 2008. The study included 10 matched population controls per case. Conditional logistic regression was used to compute adjusted ORs for NTM pulmonary disease with regard to chronic respiratory disease history. Results Overall, chronic respiratory disease was associated with a 16.5-fold (95% CI 12.2 to 22.2) increased risk of NTM pulmonary disease. The adjusted OR for NTM disease was 15.7 (95% CI 11.4 to 21.5) for COPD, 7.8 (95% CI 5.2 to 11.6) for asthma, 9.8 (95% CI 2.03 to 52.8) for pneumoconiosis, 187.5 (95% CI 24.8 to 1417.4) for bronchiectasis, and 178.3 (95% CI 55.4 to 574.3) for tuberculosis history. ORs were 29.1 (95% CI 13.3 to 63.8) for patients with COPD on current ICS therapy and 7.6 (95% CI 3.4 to 16.8) for patients with COPD who had never received ICS therapy. Among patients with COPD, ORs increased according to ICS dose, from 28.1 for low-dose intake to 47.5 for high-dose intake (more than 800 μg/day). The OR was higher for fluticasone than for budesonide. Conclusion Chronic respiratory disease, particularly COPD treated with ICS therapy, is a strong risk factor for NTM pulmonary disease.read more
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Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary
Claus Vogelmeier,Gerard J. Criner,Fernando J. Martinez,Antonio Anzueto,Peter J. Barnes,Jean Bourbeau,Bartolome R. Celli,Rongchang Chen,Marc Decramer,Leonardo M. Fabbri,Peter Frith,David M.G. Halpin,M. Victorina López Varela,Masaharu Nishimura,Nicolas Roche,Roberto Rodriguez-Roisin,Don D. Sin,Dave Singh,Robert Stockley,Jørgen Vestbo,Jadwiga A. Wedzicha,Alvar Agusti +21 more
TL;DR: The assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation, and the concept of deescalation of therapy is introduced in the treatment assessment scheme.
Journal ArticleDOI
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary
Claus Vogelmeier,Gerard J. Criner,Fernando J. Martinez,Antonio Anzueto,Peter J. Barnes,Jean Bourbeau,Bartolome R. Celli,Rongchang Chen,Marc Decramer,Leonardo M. Fabbri,Peter Frith,David M.G. Halpin,M. Victorina López Varela,Masaharu Nishimura,Nicolas Roche,Roberto Rodriguez-Roisin,Don D. Sin,Dave Singh,Robert Stockley,Jørgen Vestbo,Jadwiga A. Wedzicha,Alvar Agusti +21 more
TL;DR: The assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation, and the concept of de-escalation of therapy is introduced in the treatment assessment scheme.
Journal ArticleDOI
Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary
Claus Vogelmeier,Gerard J. Criner,Fernando J. Martinez,Antonio Anzueto,Peter J. Barnes,Jean Bourbeau,Bartolome R. Celli,Rongchang Chen,Marc Decramer,Leonardo M. Fabbri,Peter Frith,David M.G. Halpin,M. Victorina López Varela,Masaharu Nishimura,Nicolas Roche,Roberto Rodriguez-Roisin,Don D. Sin,Dave Singh,Robert Stockley,Jørgen Vestbo,Jadwiga A. Wedzicha,Alvar Agusti +21 more
TL;DR: The assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation, and the concept of de‐escalation of therapy is introduced in the treatment assessment scheme.
Journal ArticleDOI
Epidemiology of human pulmonary infection with nontuberculous mycobacteria: a review.
TL;DR: Host factors important to the current epidemiology of NTM pulmonary disease include thoracic skeletal abnormalities, rheumatoid arthritis, and use of immunomodulatory drugs.
Journal ArticleDOI
British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD)
Charles S. Haworth,John Banks,Toby Capstick,Andrew J. Fisher,Thomas Gorsuch,Ian F. Laurenson,Andrew R. Leitch,Michael R. Loebinger,Heather Milburn,Mark Nightingale,Peter Ormerod,Delane Shingadia,David Smith,Nuala Whitehead,Robert Wilson,R. Andres Floto,R. Andres Floto +16 more
TL;DR: Recommendations and recommendations on what samples should be used to detect pulmonary non-tuberculous mycobacterial infection and how to define lung disease attributable to NTM infection are presented.
References
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Safety of inhaled budesonide: clinical manifestations of systemic corticosteroid-related adverse effects.
TL;DR: In summary, based on 25 years of experience with different doses and in different populations, inhaled budesonide therapy only in very rare cases appears to be associated with an increased risk of adrenal crisis, reduction in final height, increases in the number of fractures or complications during pregnancy.
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