Chronic respiratory disease, inhaled corticosteroids and risk of non-tuberculous mycobacteriosis

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 st...

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Vydáno v:	Thorax Ročník 68; číslo 3; s. 256 - 262
Hlavní autoři:	Andréjak, Claire, Nielsen, Rikke, Thomsen, Vibeke Ø, Duhaut, Pierre, Sørensen, Henrik Toft, Thomsen, Reimar Wernich
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England BMJ Publishing Group Ltd and British Thoracic Society 01.03.2013 BMJ Publishing Group LTD
Témata:	Administration, Inhalation Aged Androstadienes - therapeutic use Anti-Inflammatory Agents - administration & dosage Anti-Inflammatory Agents - adverse effects Anti-Inflammatory Agents - therapeutic use Asthma - drug therapy Asthma - epidemiology Atypical mycobacteria infections bacterial infection Bronchiectasis - drug therapy Bronchiectasis - epidemiology Budesonide - therapeutic use Case-Control Studies case–control study Chronic Disease Chronic obstructive pulmonary disease clinical epidemiology Comorbidity Confidence Intervals corticosteroids Denmark - epidemiology Female Fluticasone Humans Male Middle Aged Mycobacterium Mycobacterium Infections, Nontuberculous - chemically induced Mycobacterium Infections, Nontuberculous - epidemiology Odds Ratio Pneumoconiosis - drug therapy Pneumoconiosis - epidemiology pneumonia Pulmonary Disease, Chronic Obstructive - drug therapy Pulmonary Disease, Chronic Obstructive - epidemiology pulmonary embolism respiratory infection Respiratory Tract Diseases - drug therapy Respiratory Tract Diseases - epidemiology Risk Factors Steroids tuberculosis Tuberculosis, Pulmonary - drug therapy Tuberculosis, Pulmonary - epidemiology Denmark
ISSN:	0040-6376, 1468-3296, 1468-3296
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Shrnutí:	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.
Bibliografie:	href:thoraxjnl-68-256.pdf ark:/67375/NVC-MCJG6RGW-9 istex:DBA6FA2BE8903FCEA3301618A5178824CC60D074 ArticleID:thoraxjnl-2012-201772 PMID:22781123 local:thoraxjnl;68/3/256 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0040-6376 1468-3296 1468-3296
DOI:	10.1136/thoraxjnl-2012-201772