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Incidence of oral t...
Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids : Effect of drug, dose, and device
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- Dekhuijzen, P. N Richard (author)
- Radboud University Nijmegen
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- Batsiou, Maria (author)
- Cambridge Research Support Ltd
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- Bjermer, Leif (author)
- Lund University,Lunds universitet,Lungmedicin, allergologi och palliativ medicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Respiratory Medicine, Allergology, and Palliative Medicine,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Bosnic-Anticevich, Sinthia (author)
- University of Sydney
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- Chrystyn, Henry (author)
- Plymouth University
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- Papi, Alberto (author)
- University of Ferrara
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- Rodríguez-Roisin, Roberto (author)
- University of Barcelona
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- Fletcher, Monica (author)
- Education for Health
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- Wood, Lucy (author)
- Observational and Pragmatic Research Institute Pte Ltd
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- Cifra, Alessandra (author)
- Observational and Pragmatic Research Institute Pte Ltd,Cambridge Research Support Ltd
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- Soriano, Joan B. (author)
- Autonomous University of Madrid
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- Price, David B. (author)
- University of Aberdeen
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(creator_code:org_t)
- Elsevier BV, 2016
- 2016
- English 10 s.
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In: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 120, s. 54-63
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Abstract
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- Background and aims Little information is available on real-life occurrence of oral thrush in COPD patients treated with ICS. We investigated oral thrush incidence in COPD patients prescribed FDC ICS/LABA therapies and assessed whether it is modulated by the ICS type, dose, and delivery device. Methods We conducted a historical, observational, matched cohort study (one baseline year before and one outcome year after initiation of therapy) using data from the UK Optimum Patient Care Research Database. We assessed oral thrush incidence in patients initiating long-acting bronchodilators or FDC ICS/LABA therapy. We then compared different combination therapies (budesonide/formoterol fumarate dihydrate [BUD/FOR] and fluticasone propionate/salmeterol xinafoate [FP/SAL]) and devices (DPI and pMDI). Results Patients prescribed FDC ICS/LABA had significantly greater odds of experiencing oral thrush than those prescribed long-acting bronchodilators alone (adjusted OR 2.18 [95% CI 1.84–2.59]). Significantly fewer patients prescribed BUD/FOR DPI developed oral thrush compared with FP/SAL DPI (OR 0.77 [0.63–0.94]) when allowing for differences in prescribed doses between the drugs. A significantly smaller proportion of patients developed oral thrush in the FP/SAL pMDI arm than in the FP/SAL DPI arm (OR 0.67 [0.55–0.82]). Additionally, in the FP/SAL cohort (both DPI and pMDI), increased risk of oral thrush was significantly associated with high ICS daily dose (OR 1.97 [1.22–3.17] vs low daily dose). Conclusions ICS use increases oral thrush incidence in COPD and this effect is dose-dependent for FP/SAL therapies. Of the therapies assessed, FP/SAL pMDI and BUD/FOR DPI may be more protective against oral thrush.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
Keyword
- Chronic obstructive pulmonary disease
- Dry powder inhaler
- Inhaled corticosteroid
- Oral candidiasis
- Pressurised metered-dose inhaler
- Spacer
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Dekhuijzen, P. N ...
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Batsiou, Maria
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Bjermer, Leif
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Bosnic-Anticevic ...
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Chrystyn, Henry
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Papi, Alberto
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Rodríguez-Roisin ...
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Fletcher, Monica
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Wood, Lucy
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Cifra, Alessandr ...
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Soriano, Joan B.
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Price, David B.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Respiratory Medi ...
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Respiratory Medi ...
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Lund University