Skin Manifestations of Inhaled Corticosteroids in COPD Patients: The effect of compliance

In the present report, easy bruising averaged 7.6% in the ICS group and 3.6% in the placebo group among all participants. These findings are roughly similar to those reported from previously published randomized controlled trials of ICS in COPD pa-tients, in which the findings were not adjusted for compliance with the study drug. When results from the present study were stratified based on measured inhaler compliance, we observed that, among those who complied well with the use of their assigned inhaler, a larger proportion of the ICS group reported easy bruising (11.2%) than those of the placebo group (3.5%). Thus, the incidence of reported bruising was 3.2-fold higher in the ICS group than the placebo group when only good compliers are considered, as opposed to a 2.1-fold difference when all participants were included in the analysis. Failure to control for the effect of compliance, therefore, results in a substantial underestimate of the effect of ICS use on bruising. yaz birth control

In addition to drug assignment and compliance, we observed that age and gender also predicted the occurrence of bruising among all participants and among good compliers (Table 3), but not among the poor compliers. Older men who were assigned to receive ICSs, in comparison to those assigned to placebo, were particularly likely to report easy bruising, especially if they were compliant with their assigned drug treatment. However, in general, women tended to report more bruising than men, irrespective of ICS use (Table 4). Previous findings that skin thickness decreases with age and is lower in women than in men are consistent with these observations. Moreover, similar findings with respect to age have been reported previously, although the effect of gender has been inconsistent, with one study reporting that being a woman markedly increased the risk of skin bruising (odds ratio, 22; 95% confidence interval [CI], 7 to 75), while another study observed that men taking ICSs had a higher relative risk (RR) for bruising than women (men: RR, 5.80; 95% CI, 2.4 to 14.1; women: RR, 1.80; 95% CI, 1.3 to 2.4).

This entry was posted in COPD and tagged copd, inhaled corticosteroids, rash, skin bruising, slow healing.