| The use of inhaled corticosteroids and the risk of adrenal insufficiency. | |
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MedLine Citation:
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PMID: 23060630 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Adrenal insufficiency is a potential complication of therapy with inhaled corticosteroids (ICS). Although prior studies found the highest risk of adrenal insufficiency with fluticasone, a more potent ICS, these results might be explained by a channeling bias and concomitant exposure to oral corticosteroids.We re-examined the relationship between the use of ICS and adrenal insufficiency by using a cohort of patients treated for respiratory conditions during 1990-2005, identified in the healthcare databases from the province of Quebec, Canada, with follow-up until 2007. A nested case-control analysis was performed within this cohort. Cases of adrenal insufficiency were matched with up to 10 controls.392 cases were identified (incidence rate=1.1/10,000 person-years). Although the rate of adrenal insufficiency was not significantly higher among all current users of ICS, patients receiving the highest dosages showed a greater risk (OR=1.84; 95% CI: 1.16-2.90). Consistently, an increased risk was estimated for the highest tertile of ICS dose (OR=1.90; 95% CI: 1.07-3.37) cumulated in the year before the event.Inhaled corticosteroids at high doses appear to be a significant independent risk factor for adrenal insufficiency. Physicians prescribing ICS at such dosages should be sensitive to the signs and symptoms of adrenal insufficiency in their patients. |
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Authors:
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Francesco Lapi; Abbas Kezouh; Samy Suissa; Pierre Ernst |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-11 |
Journal Detail:
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Title: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology Volume: - ISSN: 1399-3003 ISO Abbreviation: Eur. Respir. J. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Lady Davis Research Institute, Jewish General Hospital, Montreal, Quebec (Canada). |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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