{"doi":"10.1370/afm.240030","title":"Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease","abstract":"<h3>PURPOSE</h3> We aimed to assess long-term inhaled corticosteroid (ICS) risks in chronic obstructive pulmonary disease (COPD) management. <h3>METHODS</h3> We extracted electronic health record data for individuals aged &gt;45 years with COPD from a data repository. The prevalent cohort required a diagnosis of COPD any time during the observation period, and the inception cohort required a diagnosis of COPD made after entry into the database. A composite outcome of any new diagnosis of type 2 diabetes, cataracts, pneumonia, osteoporosis, or nontraumatic fracture; and recurrent event outcomes of repeated pneumonia or nontraumatic fracture were compared for long-term (&gt;24 months) vs short-term (&lt;4 months) ICS exposure. <h3>RESULTS</h3> We assessed outcomes for 318,385 and 209,062 individuals in the prevalent and inception cohorts, respectively. The composite dichotomous outcome was significantly greater for long-term vs short-term ICS use for the prevalent (hazard ratio [HR] = 2.65; 95% CI, 2.62-2.68; <i>P</i> &lt;.001) and inception (HR = 2.60; 95% CI, 2.56-2.64; <i>P</i> &lt;.001) cohorts. For the inception cohort, the absolute risk difference of the composite outcome was 20.26% (29.41% minus 9.15%), with a number needed to harm of 5. Hazard ratios were significantly increased in the prevalent and inception cohorts for recurrent pneumonia (HR = 2.88; 95% CI, 2.62-3.16; <i>P</i> &lt;.001 and HR = 2.85; 95% CI, 2.53-3.22; <i>P</i> &lt;.001, respectively) and recurrent fracture (HR = 1.77; 95% CI, 1.42-2.21; <i>P</i> &lt;.001 and HR = 1.57; 95% CI, 1.20-2.06; <i>P</i> &lt;.001). <h3>CONCLUSIONS</h3> Long-term ICS use for COPD is associated with significantly greater rates of the composite outcome of type 2 diabetes, cataracts, pneumonia, osteoporosis, and nontraumatic fracture; recurrent pneumonia; and recurrent fracture.","journal":"The Annals of Family Medicine","year":2025,"id":518113,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7146,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1168575,"name":"Elisabeth Callen","orcid":"0000-0002-6989-2428","position":1,"is_corresponding":false},{"id":1385547,"name":"Gabriela Gaona-Villarreal","orcid":null,"position":2,"is_corresponding":false},{"id":919748,"name":"Asif Shaikh","orcid":"0000-0002-5116-9338","position":3,"is_corresponding":false},{"id":579395,"name":"Barbara P. Yawn","orcid":"0000-0001-7278-5810","position":4,"is_corresponding":false},{"id":443413,"name":"Wilson D. Pace","orcid":"0000-0003-1699-5471","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:49:04.756302Z","pmid":"40127974","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}