Use of inhaled corticosteroids and the risk of depressive symptoms in patients with chronic obstructive pulmonary disease

Alexander Jordan, Pradeesh Sivapalan, Josefin Ëklof, Jacob Vestergaard, Howraman Meteran, Mohamad Isam Saeed, Tor Biering-Sørensen, Anders Løkke, Filip Krag Knop, Niels Seersholm, Jens Ulrik Stæhr Jensen

Abstract

Depressive side-effects are well-known from treatment with systemic corticosteroids. It is, however, unclear whether inhaled corticosteroids (ICS) have psychiatric side-effects in patients with COPD who have an a priori high risk of depression.We conducted a nationwide cohort study among all Danish COPD outpatients, age >=40 years and no cancer. Patients were divided into four groups based on accumulated budesonide-equivalent ICS dose 1 year prior to entering the cohort. Prescription fillings of antidepressants and risk of admissions to psychiatric hospitals with either depression, anxiety or bipolar disorder was assessed by Cox proportional hazard models adjusted using inverse probability weighting.We included 49500 patients. We saw a small but dose-dependent increase in the risk of antidepressant-use with ICS cumulated dose (HR 1.08, 95.03-1.14, p = 0.0023 with low ICS use, HR 1.10, 95.04-1.15, p = 0,0005 with medium use, HR 1.19, 95.12-1.25, p lt; 0.0001 with high use). All relative to no ICS usage. Congruent with this, we found a discrete increased risk of admission to psychiatric hospitals (HR 1,23, 95 CI 1,09-1,40, p = 0,0023 with low ICS use, HR 1,38, 95,22-1,57, p lt; 0,0001 with medium use, HR 1,28, 95,13-1,36, p = 0,0002 with high use).The magnitude of the observed risk was small and should not lead to changes in prescription patterns.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA2151.This abstract was presented at the 2021 ERS International Congress, in session textquotedblleftPrediction of exacerbations in patients with COPDtextquotedblright.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
OriginalsprogEngelsk
ArtikelnummerPA2151
TidsskriftEuropean Respiratory Journal
Vol/bind58
Udgave nummersuppl 65
ISSN0903-1936
DOI
StatusUdgivet - 2021

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