Department of Chest Diseases, Aarhus University, Aalborg Sygehus, Denmark.
Respir Med. 2009 Apr;103(4):566-73. doi: 10.1016/j.rmed.2008.10.028. Epub 2009 Jan 10.
Long-acting-beta-agonists and inhaled corticosteroids are widely used in patients with obstructive lung disease. We determined the occurrence of potential side effects to inhaled steroids and long-acting-beta-agonists in an open post-marketing observational study.
A total of 158 adult patients treated with long-acting-beta-agonists and inhaled steroids because of asthma or chronic obstructive lung disease were included prospectively in a cross-sectional study from September 2004 through august 2005. A subgroup of 31 patients with minimal disease were observed prospectively after treatment reduction. The frequency and intensity of potential side effects to long-acting-beta-agonists and inhaled corticosteroids were registered on a 10-point visual analogue scale.
A total of 131 (83%) reported potential side effects to inhaled steroids. The most frequent were sore (54%) and dry (52%) throat. A total of 114 (72%) patients reported potential side effects to long-acting-beta-agonists. The most frequent were muscle cramps (62%) and muscle twisting (39%). For 5/8 potential side effects their occurrence increased with increased individual dozing. In 31 patients the mean medication with steroids and long-acting-beta-agonists was reduced by 87% and 97.5%, respectively, with side effects reduced by 62% (p<0.001) to inhaled steroids and by 91% (p<0.001) to inhaled long-acting-beta-agonists.
Potential side effects in adult patients to inhaled corticosteroids and long-acting-beta-agonists are very common with increased frequency with increased dozing. Patients are largely unaware of the association. Patients should be better informed, and the results further support tailored dozing to minimum therapy.
长效β-激动剂和吸入皮质类固醇广泛用于阻塞性肺病患者。我们在一项开放性上市后观察性研究中确定了吸入皮质类固醇和长效β-激动剂潜在副作用的发生情况。
2004 年 9 月至 2005 年 8 月，共前瞻性纳入 158 例因哮喘或慢性阻塞性肺疾病而接受长效β-激动剂和吸入皮质类固醇治疗的成年患者进行横断面研究。在治疗减少后，对 31 例疾病最小化的患者进行了前瞻性亚组观察。长效β-激动剂和吸入皮质类固醇潜在副作用的频率和强度使用 10 分视觉模拟量表进行登记。
共有 131 例（83%）报告了吸入皮质类固醇的潜在副作用。最常见的是咽喉痛（54%）和咽喉干燥（52%）。共有 114 例（72%）患者报告了长效β-激动剂的潜在副作用。最常见的是肌肉痉挛（62%）和肌肉扭曲（39%）。对于 5/8 种潜在副作用，其发生频率随个体剂量的增加而增加。在 31 例患者中，皮质类固醇和长效β-激动剂的平均用药量分别减少了 87%和 97.5%，副作用分别减少了 62%（p<0.001）和 91%（p<0.001）。
成年患者吸入皮质类固醇和长效β-激动剂的潜在副作用非常常见，随着剂量的增加而增加。患者对此认识不足。应更好地告知患者，并进一步支持个体化剂量以达到最低治疗效果。
