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Table 4 Association between inhaled steroids and outcomes

From: Quantifying the real life risk profile of inhaled corticosteroids in COPD by record linkage analysis

Outcome

Univariate hazard ratio

Multivariate hazard ratio

Other variables contained in adjusted multivariate model

(95% CI)

(95% CI)

Primary endpoints

   

New onset diabetes

Any exposure

0.88 (0.68-1.14)

0.94 (0.71-1.25)

Age*, sex, deprivation, history ICS, history oral steroids*, smoking, BMI*, primary CV history*, secondary CV history*, renal dysfunction, COPD severity

Cumulative exposure

0.71 (0.46-1.10)

0.70 (0.43-1.12)

Age*, sex, deprivation, history ICS, history oral steroid*, smoking, BMI*, primary CV history*, secondary CV history, renal dysfunction, COPD severity

Worsening of existing diabetes

Current exposure

0.94 (0.73-1.21)

0.91 (0.73-1.21)

Age*, sex, deprivation, previous ICS, history of oral steroid use, smoking, BMI, primary CV history, secondary CV history, renal dysfunction, COPD severity*

Cumulative exposure

0.57 (0.25-1.30)

0.57 (0.24-1.37)

Age*, sex, deprivation, previous ICS, history of oral steroid, smoking, BMI, primary CV history, secondary CV history, renal dysfunction, COPD severity*

Secondary endpoints

   

Hospitalisation for pneumonia

Current exposure no carryover

1.27 (1.07-1.50)

1.13 (0.94-1.36)

Age*, sex, deprivation*, previous ICS, history of oral steroid, smoking*, BMI*, primary CV history*, secondary CV history*, renal dysfunction, COPD severity*, history of diabetes*, history of pneumonia admission*

Current exposure with 180-day carryover

1.58 (1.29-1.93)

1.38 (1.09-1.74)

Hospitalisation for fracture

Cumulative exposure

1.06 (0.75-1.51)

1.08 (0.75-1.51)

Age*, sex*, deprivation, previous ICS, history of oral steroid, smoking, BMI*, primary CV history, secondary CV history, renal dysfunction, COPD severity, history of diabetes, history of fracture admission*

Cataract related outcome

Cumulative exposure

1.43 (1.11-1.83)

1.42 (1.07-1.88)

Age*, sex, deprivation, previous ICS, history of oral steroid, smoking*, BMI, primary CV history*, secondary CV history, renal dysfunction, COPD severity*, history of diabetes*, history of cataract related admission

  1. *Shows variables that were found to be significant in the model.
  2. Abbreviations: CI confidence interval, ICS inhaled corticosteroids, BMI body mass index, CV cardiovascular, COPD chronic obstructive pulmonary disease.
  3. “COPD severity” is the actual FEV1 and a percentage of predicted FEV1.