Long-term Use Of Inhaled Corticosteroids And The Benefits And Risks In Chronic Obstructive Pulmonary Disease:A Meta-analysis

ObjectiveTo evaluate the benefits and risks of long-term using of Inhaled Corticosteroids for chronic obstructive pulmonary disease by meta analysis MethodRelevant literatures were searched through authoritative databases and related meetings.All the clinic trials were RCTs, relevant with inhaled corticosteroid vs a control treatment for COPD, with at least 24 weeks of follow-up. All literatures were assessed by the inclussion and exclusion criteria, quality assessment and date and reliability were evaluated sensitivty analysis and publication bias analysis.ResultsNineteen randomized controlled trials(n = 15184) were included. In patients with stable COPD, this meta analysis showed that Inhaled corticosteroids were associated with a significantly increased risk of pneumonia(RR=0.99, 95%CI:[0.88,1.11],P=0.89).FEV1 was improved(SMD=0.75, 95%CI:[0.42,1.08],P<0.00001),but without a significantly increased risk of total mortality(RR=0.99, 95%:[0.88,1.11],P=0.89).Levels of dyspnea was relieved(SMD=-2.93, 95%CI:[-3.74,-2.12],P<0.00001), 6-MWD was increased(SMD=0.46, 95%CI:[0.33,2.59],P<0.00001),life quality was improved(SMD=-2.14 95%CI: [-2.67,-1.61 ],P<0.00001)ConclusionIn patients with stable COPD,the Inhaled corticosteroids can effectively improve the lung function FEV1, increase 6-MWD, decrease levels of dyspnea and improve life quality. The long-term use of inhaled corticosteroids is associated with a significantly increased risk of pneumonia, without a significantly increased risk of death.There are a small mumber of RCTs on long-term using inhaled corticosteroids hormone-related risks such as tuberculosis, blood pressure, blood sugar, osteoporosis and fracture.Large-scale studies are still needed to further clarify the long term using inhaled corticosteroids hormone-related risks...