Lack of Association between Inhaled Corticosteroid Use and the Risk of Future Exacerbation in Patients with GOLD Group A Chronic Obstructive Pulmonary Disease

Shin, Sun Hye; Kim, Deog Kyeom; Kim, Sang-Heon; Shin, Tae Rim; Jung, Ki-Suck; Yoo, Kwang Ha; Hwang, Ki-Eun; Park, Hye Yun; Jo, Yong Suk; on behalf of the KOCOSS Cohort,

doi:10.3390/jpm12060916

Open AccessArticle

Lack of Association between Inhaled Corticosteroid Use and the Risk of Future Exacerbation in Patients with GOLD Group A Chronic Obstructive Pulmonary Disease

by

Sun Hye Shin

¹,

Deog Kyeom Kim

²,

Sang-Heon Kim

³,

Tae Rim Shin

^4,5,

Ki-Suck Jung

^4,6,

Kwang Ha Yoo

⁷,

Ki-Eun Hwang

⁸

,

Hye Yun Park

^1,*,†,

Yong Suk Jo

^9,*,†

and

on behalf of the KOCOSS Cohort

^‡

¹

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea

²

Department of Internal Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul 07061, Korea

³

Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea

⁴

Lung Research Institute, Hallym University College of Medicine, Chuncheon 24252, Korea

⁵

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Korea

⁶

Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Korea

⁷

Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University School of Medicine, Seoul 05030, Korea

⁸

Department of Internal Medicine, Wonkwang University School of Medicine, Iksan 54538, Korea

⁹

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

^‡

Membership of the KOCOSS Cohort.

J. Pers. Med. 2022, 12(6), 916; https://doi.org/10.3390/jpm12060916

Submission received: 25 April 2022 / Revised: 7 May 2022 / Accepted: 30 May 2022 / Published: 31 May 2022

(This article belongs to the Special Issue Personalized Diagnosis and Treatment of Pulmonary Diseases)

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Abstract

Background: As most clinical trials have been performed in more symptomatic and higher-risk patients, evidence regarding treatment in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A chronic obstructive pulmonary disease (COPD) is limited. We assessed the distribution of inhaler treatment and sought to investigate the association between inhaled corticosteroid (ICS) use and future exacerbation in GOLD group A COPD patients. Methods: Patients with GOLD group A COPD who received maintenance inhalers were identified from a multicentre, prospective cohort in South Korea. Patients were categorized as group A when they had fewer symptoms and did not experience severe exacerbation in the previous year. Development of moderate or severe exacerbation during the 1-year follow-up was analysed according to baseline inhaler treatment. Results: In 286 patients with GOLD group A COPD, mono-bronchodilator (37.8%), dual-bronchodilator (29.0%), triple therapy (17.5%), and ICS/long-acting beta-2 agonist (15.4%) were used. Compared to patients without ICS-containing inhalers (N = 191), those using ICS (N = 95) were more dyspnoeic, and more likely to have asthma history, lower lung function, and bronchodilator response. During the 1-year follow-up, moderate or severe exacerbations occurred in 66 of 286 (23.1%) patients. In the multivariable logistic regression analysis, ICS-containing inhaler use was not associated with the development of exacerbation, even in the subgroup with a high probability of asthma–COPD overlap. Conclusion: Although about one-third of patients with GOLD group A COPD were using ICS-containing inhalers, use of ICS was not associated with a reduction in the future development of exacerbation.

Keywords: COPD; exacerbation; inhaled corticosteroid; inhaler

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MDPI and ACS Style

Shin, S.H.; Kim, D.K.; Kim, S.-H.; Shin, T.R.; Jung, K.-S.; Yoo, K.H.; Hwang, K.-E.; Park, H.Y.; Jo, Y.S.; on behalf of the KOCOSS Cohort. Lack of Association between Inhaled Corticosteroid Use and the Risk of Future Exacerbation in Patients with GOLD Group A Chronic Obstructive Pulmonary Disease. J. Pers. Med. 2022, 12, 916. https://doi.org/10.3390/jpm12060916

AMA Style

Shin SH, Kim DK, Kim S-H, Shin TR, Jung K-S, Yoo KH, Hwang K-E, Park HY, Jo YS, on behalf of the KOCOSS Cohort. Lack of Association between Inhaled Corticosteroid Use and the Risk of Future Exacerbation in Patients with GOLD Group A Chronic Obstructive Pulmonary Disease. Journal of Personalized Medicine. 2022; 12(6):916. https://doi.org/10.3390/jpm12060916

Chicago/Turabian Style

Shin, Sun Hye, Deog Kyeom Kim, Sang-Heon Kim, Tae Rim Shin, Ki-Suck Jung, Kwang Ha Yoo, Ki-Eun Hwang, Hye Yun Park, Yong Suk Jo, and on behalf of the KOCOSS Cohort. 2022. "Lack of Association between Inhaled Corticosteroid Use and the Risk of Future Exacerbation in Patients with GOLD Group A Chronic Obstructive Pulmonary Disease" Journal of Personalized Medicine 12, no. 6: 916. https://doi.org/10.3390/jpm12060916

APA Style

Shin, S. H., Kim, D. K., Kim, S.-H., Shin, T. R., Jung, K.-S., Yoo, K. H., Hwang, K.-E., Park, H. Y., Jo, Y. S., & on behalf of the KOCOSS Cohort. (2022). Lack of Association between Inhaled Corticosteroid Use and the Risk of Future Exacerbation in Patients with GOLD Group A Chronic Obstructive Pulmonary Disease. Journal of Personalized Medicine, 12(6), 916. https://doi.org/10.3390/jpm12060916

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Lack of Association between Inhaled Corticosteroid Use and the Risk of Future Exacerbation in Patients with GOLD Group A Chronic Obstructive Pulmonary Disease

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