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Archived Comments for: Evidence suggesting that oral corticosteroids increase mortality in stable chronic obstructive pulmonary disease

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  1. Additional data supporting a negative prognostic impact of oral glucocorticoids

    Magnus Ekström, Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.

    5 December 2014

    I read with interest the paper by Horita et al., which is an observational study of the association between exposure to oral glucocorticoids and overall survival among COPD patients in the placebo arm of a randomized trial.

    The finding that oral glucocorticoids were associated with increased mortality, hazard ratio around 1.5, is strikingly consistent with a recent paper by our group.[1] This was a prospective observational study of 2,249 patients with oxygen-dependent COPD, which evaluated time varying drug exposure and overall mortality, adjusting for multiple confounders. Mortality was increased during treatment with oral glucocorticoids as compared to unexposed time, hazard ratio 1.53 (95% confidence interval, 1.35-1.73).

    Taken together, these studies support that oral glucocorticoids may have detrimental effects on survival in severe COPD which warrats further investigation.  

    Reference: 

    1.  Ekström M, et al. AJRCCM 2013; 187(7):715-720.

    Competing interests

    None.

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