Risk of Cardiovascular Events Associated with Inhaled Corticosteroid Treatment in Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis

Overview

Journal Can Respir J

Publisher Wiley

Specialty Pulmonary Medicine

Date 2018 Aug 21

PMID 30123392

Citations 4

Authors

Xia Jing

Yufeng Li

Jianying Xu

Affiliations

Soon will be listed here.

Abstract

Background: The cardiovascular (CV) safety of inhaled corticosteroids (ICSs) in chronic obstructive pulmonary disease (COPD) is controversial because different studies have suggested that ICSs either increase or reduce the risk of CV events in COPD patients. In this meta-analysis, we assess the CV safety of ICS therapy in COPD.

Methods: A meta-analysis of randomized, double-blind, parallel-group, placebo-controlled trials of ICS treatment for COPD that include at least 4 weeks of follow-up was performed. A random-effects model was used to evaluate the effects of ICS treatment on CV events. CV events were documented in each trial, and the relative risk (RR) and 95% confidence intervals (CIs) for ICSs were estimated.

Results: Thirty-one trials were included in this meta-analysis. The risk of CV events was not different between ICS-treated and control groups (RR: 0.99; 95% CI: 0.93 to 1.06; =0.801). In a subgroup analysis, there were no significant differences in CV events between an ICS combined with long-acting agonist (LABA) (ICS + LABA) group and an LABA-only group (RR: 1.00; 95% CI: 0.90 to 1.10; =0.930), as well as between a combination group (ICS + LABA) and a long-acting muscarinic antagonist (LAMA) combined with LABA (LAMA + LABA) group (RR: 0.78; 95% CI: 0.39 to 1.55; =0.473). In addition, there was no difference in the risk of CV events between ICS treatment and control groups (RR: 0.99; 95% CI: 0.90 to 1.09; =0.872).

Conclusions: These results demonstrate that ICSs do not increase the risk of CV events in COPD patients.

Citing Articles

Exploring the Impact of Inhaled Corticosteroids on Endothelial Function in Chronic Obstructive Pulmonary Disease Patients Undergoing Pulmonary Rehabilitation.

Ambrosino P, Candia C, Merola C, Lombardi C, Mancusi C, Matera M J Clin Med. 2024; 13(19).

PMID: 39407809 PMC: 11476678. DOI: 10.3390/jcm13195749.

Inhaled Corticosteroids and Risk of Cardiovascular Disease in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Regression.

Gadhvi K, Kandeil M, Raveendran D, Choi J, Davies N, Nanchahal S Chronic Obstr Pulm Dis. 2023; 10(3):317-327.

PMID: 37289196 PMC: 10484493. DOI: 10.15326/jcopdf.2022.0386.

Thromboembolic Events in Users of Warfarin Treated with Different Skeletal Muscle Relaxants.

Leonard C, Brensinger C, Bilker W, Soprano S, Dhopeshwarkar N, Hecht T Medicina (Kaunas). 2022; 58(9).

PMID: 36143848 PMC: 9501796. DOI: 10.3390/medicina58091171.

Association between inhaled corticosteroids and upper respiratory tract infection in patients with chronic obstructive pulmonary disease: a meta-analysis of randomized controlled trials.

Chen H, Feng Y, Wang K, Yang J, Du Y BMC Pulm Med. 2020; 20(1):282.

PMID: 33115481 PMC: 7594481. DOI: 10.1186/s12890-020-01315-3.

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