- A large matched cohort study finds that patients with COPD who are initiated on inhaled corticosteroids (ICS) at mean daily doses of ≥500 μg (vs lower daily doses) are at risk for onset of type 2 diabetes mellitus (T2DM), progression of T2DM, and onset of osteoporosis.
Why this matters
- Patients with COPD initiated on ICS should be monitored for T2DM and osteoporosis.
- Matched cohort study using 2 large UK primary care databases: the Clinical Practice Research Datalink and the Optimum Patient Care Research Database (1983-2016).
- Patients were divided into 3 cohorts:
- T2DM cohort (n=17,970).
- T2DM progression cohort (n=804).
- Osteoporosis cohort (n=19,898).
- Funding: None disclosed.
- Initiation of ICS therapy (vs long-acting bronchodilator [LABD]) was associated with a 27% increase in risk for T2DM (adjusted HR [aHR], 1.27; 95% CI, 1.07-1.50), but no increase in T2DM progression risk (aHR, 1.04; 95% CI, 0.87-1.25) or osteoporosis risk (aHR, 1.13; 95% CI, 0.93-1.39).
- ICS at mean daily doses ≥500 μg (vs
- Retrospective, observational design.