Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma

Abstract

OBJECTIVE: To describe and characterize local adverse effects (in the oral cavity, pharynx, and larynx) associated with the use of inhaled corticosteroids (ICSs) in patients with moderate or severe asthma. METHODS: This was a cross-sectional study involving a convenience sample of 200 asthma patients followed in the Department of Pharmaceutical Care of the Bahia State Asthma and Allergic Rhinitis Control Program Referral Center, located in the city of Salvador, Brazil. The patients were ≥ 18 years of age and had been using ICSs regularly for at least 6 months. Local adverse effects (irritation, pain, dry throat, throat clearing, hoarseness, reduced vocal intensity, loss of voice, sensation of thirst, cough during ICS use, altered sense of taste, and presence of oral candidiasis) were assessed using a 30-day recall questionnaire. RESULTS: Of the 200 patients studied, 159 (79.5%) were women. The mean age was 50.7 ± 14.4 years. In this sample, 55 patients (27.5%) were using high doses of ICS, with a median treatment duration of 38 months. Regarding the symptoms, 163 patients (81.5%) reported at least one adverse effect, and 131 (65.5%) had a daily perception of at least one symptom. Vocal and pharyngeal symptoms were identified in 57 (28.5%) and 154 (77.0%) of the patients, respectively. The most commonly reported adverse effects were dry throat, throat clearing, sensation of thirst, and hoarseness. CONCLUSIONS: Self-reported adverse effects related to ICS use were common among the asthma patients evaluated here.

Burden of serious fungal infections in the Czech Republic

“…Up to 70% of those who do not rinse after inhaling are reported to have oral candidiasis, however, of those who do rinse, it is estimated that 6% suffer with this side effect. 21,22 In our estimates, we have assumed that all patients using ICS in long term do rinse.…”

“…The number of pulmonary tuberculosis (PTB) cases 23 were obtained from the Czech Institute of Health Information and Statistics (IHIS) and using the approach taken by Denning et al [24] in their global estimates, where the number of annual PTB cases with cavities (12%) was multiplied by the incidence of CPA in cavities (22%) and the number of PTB cases without cavities (88%) was multiplied by CPA incidence (2%). The 5-year point prevalence of chronic pulmonary aspergillosis (CPA) was estimated based on previously estimated incidence rate using a 3.152 index.…”

“…Given these estimates, in this population, there are likely 1316-14 712 (Best guess 4701) patients with allergic bronchopulmonary aspergillosis (ABPA) 29 and 5641-16 814 more people (Best guess 6581) having severe asthma with fungal sensitisation (SAFS). 30 Based on 70% asthma patients in respiratory practice using ICS and 6% of them having oral candidiasis, there are estimated 7558 ICS users who have oral candidiasis 21,22 (Table 1).…”

“…The total numbers of patients with COPD of all GOLD stages obtained from the Annual Report of patients registered and followed up by a respiratory specialist in 2012 was 263 753 in 2012. 23 The OECD self-reported COPD prevalence was 2.7%, which would correspond to 241 755 people living with COPD. As there were 15 826 COPD admissions in 2012, and given that 1.3% of COPD admissions have or develop IA, based on Spanish data, 32 this would result in 206 cases of IA in COPD, predominantly in intensive care.…”

A Framework for Identifying Genotypic Information from Clinical Records: Exploiting Integrated Ontology Structures to Transfer Annotations between ICD Codes and Gene Ontologies

“…We found a strong support in the literature for several overlapping associations. For instance, Advair is one of the primary medicines for treating the patients with Asthma (C0004096), however, it is reported that oral candidiasis (C0006840) is one of the sideeffect of this treatment [37]. A study [38] reported a 45-years old woman with increasing retrosternal tenderness as well as esophagitis (C0014868) that had benign tumor classified as cavernous haemangioma (C0018916).…”