A population based case-control study of cataract and inhaled corticosteroids

Smeeth, Liam; Boulis, Magdy; Hubbard, Richard; Fletcher, A. E.

doi:10.1136/bjo.87.10.1247

Cited by 95 publications

(69 citation statements)

References 23 publications

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“…Growth velocity does transiently decrease with initiation of inhaled corticosteroid treatment in prepubertal children, but this effect does not seem to result in diminution of actual height attained. 17,18 The risk of developing either cataracts 19,20 or osteoporosis 21 is small. Skin bruising does occur with long-term use of inhaled corticosteroids, especially in the elderly, but this is primarily a cosmetic problem.…”

Section: Introductionmentioning

confidence: 99%

Categorizing Asthma Severity: An Overview of National Guidelines

Colice¹

2004

Clinical Medicine & Research

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Section: Introductionmentioning

confidence: 99%

Categorizing Asthma Severity: An Overview of National Guidelines

Colice¹

2004

Clinical Medicine & Research

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“…The patient-doctor consultation rate was also considered a potential confounder because the frequency of consultation may influence the likelihood of both cataract diagnosis and drug prescription, and this variable has been shown to be an important confounder in previous studies using this database. 24 The mean annual consultation rate for each participant was calculated by dividing the total number of consultations by the years of observation prior to the index date.…”

Section: Methodsmentioning

confidence: 99%

Hormone replacement therapy and cataract: a population-based case–control study

Aina

Smeeth

Hubbard

et al. 2005

Eye

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Purpose Laboratory studies have suggested that hormone replacement therapy (HRT) may protect against the development of cataract, but epidemiological studies in humans have thus far been inconclusive. The aim of this study was to assess the association between hormone replacement therapy and cataract. Methods Population-based case-control study using data from the General Practice Research Database in the UK. Participants were 10 000 women aged 45 years and over with diagnosed cataract and 10 000 controls matched on age, general practice, and calendar period. Results The crude odds ratio for the association between cataract and ever-use of oestrogen-only hormone replacement therapy was 1.13 (95% CI 0.99-1.29). This reduced to 0.81 (95% CI 0.71-0.94) after adjustment for consultation rate. Similarly, the crude odds ratio for the association between cataract and ever-use of a formulation containing oestrogen and progestogen was 1.18 (95% CI 1.01-1.39), reducing to 0.86 (95% CI 0.72-1.02) after adjustment for consultation rate. Conclusions Oestrogen-only and oestrogenprogestogen hormone replacement therapies are associated with a small reduced risk of cataract. This data adds to the growing body of evidence on the effects of HRT on health. All potential benefits and risks of this therapy should be taken into account when considering its use.

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“…More recently, a meta-analysis [36] on two databases from UK and Canada on the use of ICS in adult and elderly patients concluded that the risk of cataracts increased by about 25 % for each 1,000 lg increase in daily dose of beclomethasone dipropionate or equivalent. Thus, although no firm link between cataract formation and ICS use has been made to date, the lowest possible ICS dose is recommended to minimize ocular complications [37].…”

Section: Cataractmentioning

confidence: 99%

Erratum to: Safety Considerations of Inhaled Corticosteroids in the Elderly

et al. 2015

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Inhaled corticosteroids (ICSs) are widely used in the treatment of patients with chronic obstructive pulmonary diseases. However, high-dose regimens and longterm use of ICSs have the potential to cause a variety of local and systemic side effects such as candidiasis, cataracts, glaucoma, and osteoporosis. The use of ICSs can also be associated with the risk of bone fractures, diabetes mellitus and pneumonia. These ICS-related side effects are of particular importance in elderly patients due to the presence of comorbidities and age-related behavioral, cognitive, and psychological problems, which can all interact with inhaled treatment. We reviewed the available literature on the clinically relevant side effects of ICSs in the elderly to provide practical measures to properly monitor and manage the risk of ICSs in the geriatric population. Inspection of the mouth, monitoring of ocular pressure, and use of bone-protective drugs may be necessary in patients on prolonged ICS therapy. Above all, the use of the lowest possible ICS dose and a careful re-assessment of the inhalation procedure should be recommended. Taken together, these observations suggest that physicians should use ICSs appropriately for those patients in whom the benefit will outweigh the risk, especially chronic obstructive pulmonary disease (COPD) patients with previous frequent exacerbations. Given the paucity of information on the topic and the need to extrapolate the results from studies with broader age ranges, we strongly encourage the design of specifically tailored clinical studies in the elderly. Key PointsAsthma and chronic obstructive pulmonary disease (COPD) are inflammatory disorders of the airways. The pharmacological management of these chronic diseases is based on persistent and long-term use of inhaled corticosteroids (ICSs).Asthma and COPD are among the most common chronic diseases in clinical settings, and physicians are expected to diagnose and manage those diseases in the geriatric population on a daily basis. The management of chronic obstructive respiratory diseases in the geriatric population is complicated by the increased occurrence of comorbidities and associated treatment, and by age-associated physiological and structural changes of the lung.The chronic use of ICSs in the elderly is associated with the increased risk of local and systemic side effects such as candidiasis, cataract, glaucoma, diabetes mellitus, bone fractures, and pneumonia. Physicians should be aware of this in order to select those patients in whom the benefits will outweigh the risks.The online version of the original article can be found under

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A population based case-control study of cataract and inhaled corticosteroids

Cited by 95 publications

References 23 publications

Categorizing Asthma Severity: An Overview of National Guidelines

Categorizing Asthma Severity: An Overview of National Guidelines

Hormone replacement therapy and cataract: a population-based case–control study

Erratum to: Safety Considerations of Inhaled Corticosteroids in the Elderly

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