Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, 610031, People's Republic of China.
Department of Pharmacology, Faculty of Medicine, University of the Basque Country, UPV/EHU, Leioa, Spain.
Int J Chron Obstruct Pulmon Dis. 2024 Jun 25;19:1457-1469. doi: 10.2147/COPD.S466588. eCollection 2024.
This study conducted a pharmacovigilance analysis based on the FDA Adverse Event Reporting System (FAERS) database to compare the infection risk of inhaled or nasal Beclomethasone, Fluticasone, Budesonide, Ciclesonide, Mometasone, and Triamcinolone Acetonide.
We used proportional imbalance analysis to evaluate the correlation between ICS /INCs and infection events. The data was extracted from the FAERS database from April 2015 to September 2023. Further analysis was conducted on the clinical characteristics, site of infection, and pathogenic bacteria of ICS and INCs infection adverse events (AEs). We used bubble charts to display their top 5 infection adverse events.
We analyzed 21,837 reports of infection AEs related to ICS and INCs, with an average age of 62.12 years. Among them, 61.14% of infection reports were related to females. One-third of infections reported to occur in the lower respiratory tract with Fluticasone, Budesonide, Ciclesonidec, and Mometasone; over 40% of infections reported by Triamcinolone Acetonide were eye infections; the rate of oral infections caused by Beclomethasone were 7.39%. The reported rates of fungal and viral infections caused by beclomethasone were 21.15% and 19.2%, respectively. The mycobacterial infections caused by Budesonide and Ciclesonidec account for 3.29% and 2.03%, respectively. Bubble plots showed that the ICS group had more fungal infections, oral infections, pneumonia, tracheitis, etc. The INCs group had more eye symptoms, rhinitis, sinusitis, nasopharyngitis, etc.
Women who use ICS and INCs are more prone to infection events. Compared to Budesonide, Fluticasone seemed to have a higher risk of pneumonia and oral candidiasis. Mometasone might lead to more upper respiratory tract infections. The risk of oral infection was higher with Beclomethasone. Beclomethasone causes more fungal and viral infections, while Ciclesonide and Budesonide are more susceptible to mycobacterial infections.
本研究基于美国食品药品监督管理局不良事件报告系统（FAERS）数据库进行药物警戒分析，比较吸入或鼻用倍氯米松、氟替卡松、布地奈德、环索奈德、莫米松和曲安奈德的感染风险。
我们使用比例失衡分析来评估 ICS/INCs 与感染事件之间的相关性。数据来自 FAERS 数据库，时间范围为 2015 年 4 月至 2023 年 9 月。进一步分析了 ICS 和 INCs 感染不良事件（AE）的临床特征、感染部位和致病菌。我们使用气泡图显示了它们前 5 种感染不良事件。
我们分析了 21837 份与 ICS 和 INCs 相关的感染 AE 报告，平均年龄为 62.12 岁。其中，61.14%的感染报告与女性有关。三分之一的感染报告发生在下呼吸道，与氟替卡松、布地奈德、环索奈德和莫米松有关；超过 40%的曲安奈德引起的感染为眼部感染；倍氯米松引起的口腔感染率为 7.39%。报道的由倍氯米松引起的真菌感染和病毒感染率分别为 21.15%和 19.2%。由布地奈德和环索奈德引起的分枝杆菌感染分别占 3.29%和 2.03%。气泡图显示，ICS 组有更多的真菌感染、口腔感染、肺炎、气管炎等，INCs 组有更多的眼部症状、鼻炎、鼻窦炎、鼻咽炎等。
使用 ICS 和 INCs 的女性更容易发生感染事件。与布地奈德相比，氟替卡松似乎有更高的肺炎和口腔念珠菌病风险。莫米松可能导致更多的上呼吸道感染。倍氯米松的口腔感染风险更高。倍氯米松引起的真菌感染和病毒感染更多，而环索奈德和布地奈德更容易受到分枝杆菌感染。
