Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids: Effect of drug, dose, and device

Dekhuijzen, P.N.R.; Batsiou, Maria; Bjermer, Leif; Bosnic‐Anticevich, Sinthia; Chrystyn, Henry; Papi, Alberto; Rodríguez-Roisin, Roberto; Fletcher, Monica; Wood, Lucy; Cifra, Alessandra; Soriano, Joan B.; Price, David

doi:10.1016/j.rmed.2016.09.015

Cited by 36 publications

(35 citation statements)

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“…However, as in previous studies, the following risk factors were reported: use of removable prostheses,[ 12 ] bone marrow transplantation,[ 13 ] HIV/AIDS,[ 3 14 ] chemotherapy,[ 13 15 ] diabetes mellitus[ 16 ] and use of corticosteroids. [ 17 ]…”

Section: Discussionmentioning

confidence: 99%

Oral candidiasis: A retrospective study of 276 Brazilian patients

Meira

Oliveira

Pereira

et al. 2017

J Oral Maxillofac Pathol

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Background:Although oral candidiasis (OC) is a very common fungal infection of oral cavity, clinical features of affected patients and their demographic profile are not well documented.Objective:The objective of the study was to assess the demographic profile of patients diagnosed with OC and its clinical features in an import Brazilian center of oral and maxillofacial pathology.Materials and Methods:A retrospective study consisted of 276 patients diagnosed with OC by cytopathology Periodic Acid-Schiff (PAS) staining, during the period of 20 years. The variables related to patients were gender, age and skin color. Regarding infection, the data collected were location, color, symptoms, early manifestation, or recurrent and associated factors.Results:Male and female were equally affected, and the median age was 43 years. The majority of lesions were of primitive origin, asymptomatic and affecting only one site of oral cavity. The most affected site was the palate followed by tongue. More than a half of the patients (56.2%) had red lesions. The main associated factors related were the use of removable prostheses, bone marrow transplantation and AIDS.Conclusions:OC affects predominantly adults and elderly, without difference between sex and skin color. Although clinical findings are crucial, cytopathology tests are important complementary examinations to reach a definitive diagnosis. PAS staining seems to be more used in cases of erythematous candidiasis since white lesions are easier to diagnose clinically.

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Section: Discussionmentioning

confidence: 99%

Oral candidiasis: A retrospective study of 276 Brazilian patients

Meira

Oliveira

Pereira

et al. 2017

J Oral Maxillofac Pathol

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“…Infections ICS can impair monocyte chemotaxis, bactericidal activity, interleukin (IL)-1 and tumour necrosis factor α production, and T-cell activation [59,60], thereby increasing the risk of respiratory infections such as pneumonia [15], oropharyngeal candidiasis [61][62][63], mycobacterial [64,65] and upper respiratory tract (URTIs).…”

Section: Lung Functionmentioning

confidence: 99%

Inhaled corticosteroids in COPD: friend or foe?

et al. 2018

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The efficacy, safety and positioning of inhaled corticosteroids (ICS) in the treatment of patients with chronic obstructive pulmonary disease (COPD) is much debated, since it can result in clear clinical benefits in some patients ("friend") but can be ineffective or even associated with undesired side effects, pneumonia, in others ("foe"). After critically reviewing the evidence for and against ICS treatment in patients with COPD, we propose that: 1) ICS should not be used as a single, stand-alone therapy in COPD; 2) patients most likely to benefit from the addition of ICS to long-acting bronchodilators include those with history of multiple or severe exacerbations despite appropriate maintenance bronchodilator use, particularly if blood eosinophils are>300 cells·µL, and those with a history of and/or concomitant asthma; and 3) the risk of pneumonia in COPD patients using ICS is higher in those with older age, lower body mass index, greater overall fragility, receiving higher ICS doses and those with blood eosinophils <100 cells·µL All these factors must be carefully considered and balanced in any individual COPD patient before adding ICS to her/his maintenance bronchodilator treatment. Further research is needed to clarify some of these issues and firmly establish these recommendations.

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“…Small particle size decreases oropharyngeal deposition and local adverse effects compared to the same drug with a larger aerosol size. 6,122,129 Studies in subjects with asthma and COPD indicate greater improvements in small-airway function with small-particle aerosols, which lends support to this benefit. [130][131][132][133][134][135] However, it is possible that particles that are too small (ie, Ͻ 1 m) may be less efficacious than particles of a medium size.…”

Section: Clinical Studies Supporting the Impact Of Aerosolsmentioning

confidence: 97%

“…118 Clinical and real-world studies in subjects with obstructive lung disease show differences in outcomes and adverse effects associated with less efficient DPIs. [119][120][121][122][123][124] When compared to the same drug administered with a pMDI, the Seretide Accuhaler (GlaxoSmithKline) was shown to have a higher risk of exacerbations in subjects with asthma and COPD as well as oropharyngeal adverse effects, presumably related to differences in lung and oropharyngeal deposition between the less efficient Accuhaler and pMDI. [120][121][122] In a study of pediatric subjects with asthma, it was found that formoterol DPI achieved a greater increase in FEV 1 post-exercise when inhaled at a higher inspiratory flow.…”

Section: Clinical Studies Supporting the Impact Of Aerosolsmentioning

confidence: 99%

Aerosol Delivery Devices for Obstructive Lung Diseases

Pleasants

Hess

2018

Respir Care

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Drug delivery by inhalation is the principal strategy to treat obstructive lung diseases, which affect about 15% of the population in the United States. Aerosol delivery devices have evolved over more than 60 years from the basic pressurized metered-dose inhaler and nebulizer to numerous types of inhalers and devices, including valved holder chambers, dry powder inhalers, soft mist inhalers, as well as smart inhalers and nebulizers. Although these devices improve a patient's ability to self-administer medication, many problems with optimal delivery still exist. Appropriate selection and repeated patient education can help lessen the problems with these devices. Aerosol science is evolving, with methods of measurement that include radio-scintigraphy and magnetic resonance imaging, to provide a better understanding of aerosol delivery and effects. Understanding the science and clinical application of aerosol drug delivery can substantially aid clinicians in optimizing these therapies for their patients.

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Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids: Effect of drug, dose, and device

Cited by 36 publications

References 34 publications

Oral candidiasis: A retrospective study of 276 Brazilian patients

Oral candidiasis: A retrospective study of 276 Brazilian patients

Inhaled corticosteroids in COPD: friend or foe?

Aerosol Delivery Devices for Obstructive Lung Diseases

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