A new study has found that patients with chronic obstructive pulmonary disease (COPD) who undergo long-term inhaled corticosteroid (ICS) treatment face an increased risk of serious health complications. The findings were published in the Annals of Family Medicine (March/April issue) and highlight the need for careful evaluation before prescribing prolonged ICS therapy.

The study, led by Dr. Wilson D. Pace of the DARTNet Institute in Aurora, Colorado, analyzed electronic health records of over 318,000 individuals diagnosed with COPD. The research focused on comparing health outcomes between patients on long-term ICS therapy (more than 24 months) and those using ICS for a shorter duration (less than four months).

The findings revealed a significantly higher incidence of adverse effects among long-term ICS users, including new diagnoses of type 2 diabetes, cataracts, pneumonia, osteoporosis, and nontraumatic fractures. Specifically, patients on prolonged ICS therapy had more than double the risk of these conditions compared to short-term users. Recurrent pneumonia and fractures were also notably higher in this group.

The absolute risk difference in new adverse diagnoses was 20.26% for patients who started ICS after their COPD diagnosis, meaning that one in every five long-term users experienced a harmful outcome. The study estimated that for every five patients treated long-term with ICS, one would develop a serious complication.

"The clinical use of and indications for ICS therapy in COPD should be carefully considered for each individual before initiation of long-term ICS therapy," the researchers emphasized.

The study was funded by Boehringer Ingelheim, and some authors disclosed affiliations with the pharmaceutical industry. These findings reinforce the importance of a personalized approach to COPD management, balancing the benefits of ICS therapy with its potential risks.