Demographic, physiologic and radiographic characteristics of COPD patients taking chronic systemic corticosteroids

Irene Swift, Aditi Satti, Victor Kim, Barry J Make, John Newell, Robert M Steiner, Carla Wilson, James R Murphy, Edwin K Silverman, Gerard J Criner, COPDGene® Investigators, Edwin Jacques Rudolph van Beek

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)29-35
Number of pages7
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume9
Issue number1
DOIs
Publication statusPublished - Feb 2012

Keywords

  • Administration, Oral
  • Adrenergic beta-Agonists
  • Asthma
  • Bronchodilator Agents
  • Female
  • Forced Expiratory Volume
  • Glucocorticoids
  • Humans
  • Hypersensitivity
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Nebulizers and Vaporizers
  • Oxygen
  • Oxygen Inhalation Therapy
  • Prednisone
  • Pulmonary Disease, Chronic Obstructive
  • Pulmonary Emphysema
  • Quality of Life
  • Scopolamine Derivatives
  • Severity of Illness Index
  • Smoking
  • Spirometry
  • Theophylline
  • United States
  • Walking

Fingerprint

Dive into the research topics of 'Demographic, physiologic and radiographic characteristics of COPD patients taking chronic systemic corticosteroids'. Together they form a unique fingerprint.

Cite this