Arevalo Jean C, Buban Eliza Rei D
College of Dentistry, University of the Philippines Manila.
Acta Med Philipp. 2023 Dec 18;57(12):32-38. doi: 10.47895/amp.vi0.6466. eCollection 2023.
Oral candidiasis (OC) is a well-known local side effect of inhaled corticosteroid (ICS) therapy in patients with asthma and chronic obstructive pulmonary disease (COPD). This study aimed to determine the prevalence of OC and its association with ICS-related factors in out-patient asthma and COPD patients of the Departments of Pulmonology and Pediatric Pulmonology of the Philippine General Hospital (PGH).
This is a cross-sectional study conducted from October 2019 to January 2020. Data was collected through a two-part questionnaire accomplished by doctors and patients with asthma or COPD.
A total of 67 patients were included in the study. Oral candidiasis was observed in 4 (5.97%) ICS users, and the prevalence was 1.65% to 14.59% (95% CI, SE: 0.028946).
This study determined the prevalence of oral candidiasis in asthma and COPD patients and its association with ICS-related factors, including the dosage, medication, device, and duration of therapy. The prevalence of OC in ICS users in PGH cannot be interpreted as high or low due to the small number of respondents, but is consistent with OC prevalence found in related literature. Increased prevalence was observed in adult females with asthma under low dose ICS therapy with Fluticasone/Salmeterol DPI for more than a year. There was no statistically significant correlation among OC prevalence, age, sex, and components of ICS-therapy including dosage, medication, device, frequency, and duration of therapy. A large-scale study is recommended for more accurate assessment of OC prevalence in the population and to determine statistically significant associations among the factors. It is also recommended to quantifiably measure patient compliance, inhalation technique and instruction, and its association to OC prevalence. Findings may be used to strengthen patient education, preventive measures, and disease management to facilitate improved compliance and effective treatment outcomes.
口腔念珠菌病（OC）是哮喘和慢性阻塞性肺疾病（COPD）患者吸入糖皮质激素（ICS）治疗中一种广为人知的局部副作用。本研究旨在确定菲律宾总医院（PGH）肺病科和儿科肺病科门诊哮喘和COPD患者中OC的患病率及其与ICS相关因素的关联。
这是一项于2019年10月至2020年1月进行的横断面研究。数据通过医生和哮喘或COPD患者完成的两部分问卷收集。
共有67名患者纳入研究。4名（5.97%）ICS使用者出现口腔念珠菌病，患病率为1.65%至14.59%（95%置信区间，标准误：0.028946）。
本研究确定了哮喘和COPD患者口腔念珠菌病的患病率及其与ICS相关因素的关联，包括剂量、药物、装置和治疗持续时间。由于受访者数量较少，PGH中ICS使用者的OC患病率不能解释为高或低，但与相关文献中发现的OC患病率一致。在接受低剂量氟替卡松/沙美特罗干粉吸入剂ICS治疗超过一年的成年女性哮喘患者中观察到患病率增加。OC患病率与年龄、性别以及ICS治疗的组成部分（包括剂量、药物、装置、频率和治疗持续时间）之间没有统计学上的显著相关性。建议进行大规模研究，以更准确地评估人群中OC的患病率，并确定各因素之间具有统计学意义的关联。还建议对患者的依从性、吸入技术和指导及其与OC患病率的关联进行量化测量。研究结果可用于加强患者教育、预防措施和疾病管理，以促进更好的依从性和有效的治疗效果。
