title: Demographic, physiologic and radiographic characteristics of COPD patients taking chronic systemic corticosteroids.
abstract: Long-term therapy with systemic corticosteroids is not recommended in the treatment of chronic obstructive pulmonary disease (COPD). However, experience demonstrates that some patients receive low dose therapy. Our objective was to describe the demographic, physiologic and radiologic characteristics of COPD patients treated with chronic systemic corticosteroids. We analyzed COPD subjects with GOLD I-IV disease in the COPDGene® study. Subjects were divided into 2 groups based on whether they reported using chronic oral steroids or not; 1264 subjects were included. Fifty-eight (4.5%) reported chronic systemic corticosteroid use. There were no differences in age, race, co-morbid conditions (other than asthma), or body mass index between the groups. There was a greater proportion of GOLD III (41% vs. 26%) and IV (41% vs. 13%) subjects in the group using chronic systemic corticosteroids. This group used more respiratory medications, required more oxygen (2.31 ± 0.21 vs. 0.59 ± 0.05 L/min; p < 0.0001), and walked less distance (245.4 ± 17.4 vs. 367.2 ± 3.9 meters; p < 0.0001). They reported more total (1.7 ± 0.16 vs. 0.62 ± 0.03; p < 0.0001) and severe exacerbations per year (0.41 ± 0.05 vs. 0.18 ± 0.01; p < 0.0001). BODE (5.0 ± 0.3 vs. 2.6 ± 0.1; p < 0.0001), MMRC (3.31 ± 0.19 vs. 1.90 ± 0.04; p < 0.0001) and SGRQ scores (54.9 ± 2.9 vs 53.3 ± 0.6; p < 0.0001) were higher. They also had a higher percentage of emphysema (22.4 ± 1.9 vs. 14.0 ± 0.4;%, p = <0.0001) on CT scan. COPD patients that report using chronic systemic corticosteroids have more severe clinical, physiologic, and radiographic disease.
authors.affiliation: Temple University, Philadelphia, Pennsylvania 19140, USA. iqpermut@gmail.com
authors.forename: Irene
authors.initials: I
authors.lastname: Swift
authors.forename: Aditi
authors.initials: A
authors.lastname: Satti
authors.forename: Victor
authors.initials: V
authors.lastname: Kim
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Make
authors.forename: John
authors.initials: J
authors.lastname: Newell
authors.forename: Robert M
authors.initials: RM
authors.lastname: Steiner
authors.forename: Carla
authors.initials: C
authors.lastname: Wilson
authors.forename: James R
authors.initials: JR
authors.lastname: Murphy
authors.forename: Edwin K
authors.initials: EK
authors.lastname: Silverman
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Criner
mesh_terms: D000284:Administration, Oral; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009330:Nebulizers and Vaporizers; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D011241:Prednisone / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging; D011788:Quality of Life; D012602:Scopolamine Derivatives / Q000627:therapeutic use; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry; D013806:Theophylline / Q000627:therapeutic use; D000069447:Tiotropium Bromide; D014481:United States / Q000453:epidemiology; D016138:Walking / Q000502:physiology
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D005938:Glucocorticoids; D012602:Scopolamine Derivatives; D013806:Theophylline; D010100:Oxygen; D011241:Prednisone; D000069447:Tiotropium Bromide