Prevalence of pharyngeal and laryngeal complications in adult asthmatics using inhaled corticosteroids.
OBJECTIVE
To investigate the prevalence in adults of pharyngeal and laryngeal symptoms associated with the use of inhaled corticosteroids.


METHODS
Prospective, observational and based on a structured, specifically designed postal questionnaire.


METHODS
University Hospital Aintree, Liverpool, UK.


METHODS
The questionnaire was distributed to 190 patients on the basis of current inhaled corticosteroid use. Recruitment was from the databases of two local general practices. Individuals were classified as mild, moderate or severe asthmatics, using the guidelines of the British Thoracic Society.


METHODS
Demographic data, including smoking history, were recorded. The number, type, strength, dosing regime and duration of individual inhaler use were recorded. Specific pharyngeal and laryngeal side effects were enquired about. Co-morbidities and preventive measures were also recorded. Results were analysed using univariate and multivariate statistical tests.


RESULTS
There was a 75.8 per cent response rate (144/190 questionnaires); 63 (43.8 per cent) of respondents were male and 81 (56.2 per cent) were female. The majority of our patients were either mild or moderate asthmatics. Longer use of an inhaled corticosteroid predisposed to weak voice (p = 0.0016), hoarseness (p = 0.0001) and throat irritation (p = 0.008). Hoarseness, throat irritation, sore throat and cough were observed much more frequently than anticipated. Severe asthmatics were more likely to use a spacer device compliantly (p = 0.0487; odds ratio 1.53). Side effects were more prevalent as asthma severity worsened (p = 0.0049; odds ratio 1.87).


CONCLUSIONS
Inhaled corticosteroids cause sore throats, throat irritation, hoarseness and cough. Further research in this area is required in order to elucidate the mechanism of inflammation. Only then can effective preventive measures be introduced and implemented.
Bhalla
R K
RK
Department of Otolaryngology, University Hospital Aintree, Liverpool, UK. DrRKBhalla@doctors.org.uk
Jones
A S
AS
Roland
N J
NJ
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010608:Pharyngeal Diseases / Q000139:chemically induced* / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones