Inhaled corticosteroids reduce death rate

Patients with chronic obstructive pulmonary disease (COPD) who use inhaled corticesteroids may have a significantly decreased mortality risk, according to a study by Christine Macie of Cambridge Hospital, Ontario, Canada. Patients who received inhaled corticosteroids within 30 days of hospital discharge had a 25% reduced all-cause mortality rate. Cardiovascular-related death alone in patients using steroids paired with beta-agonists is reduced by 38%.

"COPD is an undertreated lung disease that has associated heart disease;' explains Macie. "Controversy exists with respect to the effect of inhaled corticosteroids on mortality. Our study examined the effect of inhaled corticosteroids on survival, and results suggest that the survival is longer in patients using inhaled corticosteroids"

Macie and her colleagues found that the mortality rate in patients 65 and older who receive inhaled corticosteroids is 11.7%, compared with 13.1% for those who do not. Patients in the 35- to 64-year-old group show even greater results, with a mortality rate of three percent for patients receiving inhaled corticosteroids within 90 days, compared with six percent for those who do not, providing a mortality reduction rate of 53%. When patients who received steroids in the year prior are removed from the analysis, mortality is reduced by 34%. Researchers attribute this finding to multifactorial reasons, including reductions in exacerbations of the disease and suppression of inflammation.

Researchers also found a 23% reduced risk of death when comparing the effects of inhaled steroids with bronchodilators in patients in the 65 and older group. In all cases, the most significant results were found when inhaled corticosteroids were administered within the first 30 days following hospital discharge. "Our results indicate that the effect of inhaled corticosteroids is relatively short term and that those currently using it are relatively better protected," declares Macie. "Inhaled corticosteroids should be prescribed as soon as clinically indicated. By treating COPD with them, we have the potential to reduce the effect and prolong life"

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