Current Perspectives on the Contribution of Inhaled Corticosteroids to an Increased Risk for Diabetes Onset and Progression in Patients with Chronic Obstructive Pulmonary Disease

Recent studies have suggested that inhaled corticosteroids (ICS) play a role in the development of hyperglycemia and type-2 diabetes in patients with chronic obstructive pulmonary disease (COPD). Nevertheless, this corticosteroid-associated adverse effect remains controversial. Moreover, the pharmacokinetic properties and patient characteristics that might contribute to an increased risk for diabetes upon ICS exposure have not been thoroughly investigated. In the present review, we critically discuss current evidence regarding the relationship between ICS therapy in COPD patients and an increased risk for the incidence and progression of type-2 diabetes. In addition, we address therapeutic conditions, clinical implications, and future perspectives related to this potentially important ICS-associated adverse effect in COPD patients.

[1]  Kayleigh Kew,et al.  Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease. , 2014, The Cochrane database of systematic reviews.

[2]  Mark Small,et al.  Characteristics of a COPD population categorised using the GOLD framework by health status and exacerbations. , 2014, Respiratory medicine.

[3]  F. Martinez,et al.  Corrigendum to “Fluticasone furoate/vilanterol (100/25; 200/25 μg) improves lung function in COPD: A randomised trial” [Respir Med 107 (2013) 550–559] , 2013 .

[4]  B. Nordestgaard,et al.  Myocardial infarction and other comorbidities in patients with chronic obstructive pulmonary disease : a Danish Nationwide Study of 7 . 4 million individuals , 2011 .

[5]  M. Hsieh,et al.  Chronic obstructive pulmonary disease: a risk factor for type 2 diabetes: a nationwide population‐based study , 2013, European journal of clinical investigation.

[6]  H. Pinnock,et al.  Overtreatment of COPD with Inhaled Corticosteroids - Implications for Safety and Costs: Cross-Sectional Observational Study , 2013, PloS one.

[7]  H. Taniguchi,et al.  Budesonide/formoterol via Turbuhaler® versus formoterol via Turbuhaler® in patients with moderate to severe chronic obstructive pulmonary disease: Phase III multinational study results , 2013, Respirology.

[8]  J. Yim,et al.  Use of inhaled corticosteroids and the risk of tuberculosis , 2013, Thorax.

[9]  F. Martinez,et al.  Once-daily inhaled fluticasone furoate and vilanterol versus vilanterol only for prevention of exacerbations of COPD: two replicate double-blind, parallel-group, randomised controlled trials. , 2013, The Lancet. Respiratory medicine.

[10]  E. Antón How and when to use inhaled corticosteroids in chronic obstructive pulmonary disease? , 2013, Expert review of respiratory medicine.

[11]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[12]  Gillian,et al.  Comorbid Diabetes and COPD Impact of corticosteroid use on diabetes complications , 2013 .

[13]  P. Bareille,et al.  Fluticasone Furoate, a Novel Inhaled Corticosteroid, Demonstrates Prolonged Lung Absorption Kinetics in Man Compared with Inhaled Fluticasone Propionate , 2012, Clinical Pharmacokinetics.

[14]  C. Kahn,et al.  New mechanisms of glucocorticoid-induced insulin resistance: make no bones about it. , 2012, The Journal of clinical investigation.

[15]  F. Radner,et al.  Risk of new onset diabetes mellitus in patients with asthma or COPD taking inhaled corticosteroids. , 2012, Respiratory medicine.

[16]  F. Martinez,et al.  Does roflumilast decrease exacerbations in severe COPD patients not controlled by inhaled combination therapy? the REACT study protocol , 2012, International journal of chronic obstructive pulmonary disease.

[17]  I. Deary,et al.  Glucocorticoid treatment and impaired mood, memory and metabolism in people with diabetes: the Edinburgh Type 2 Diabetes Study , 2012, European journal of endocrinology.

[18]  A. Sharafkhaneh,et al.  Effect of budesonide/formoterol pMDI on COPD exacerbations: a double-blind, randomized study. , 2012, Respiratory medicine.

[19]  S. Suissa,et al.  Systemic effects of inhaled corticosteroids , 2012, Current opinion in pulmonary medicine.

[20]  S. Rennard,et al.  Efficacy and Tolerability of Budesonide/Formoterol in One Hydrofluoroalkane Pressurized Metered-Dose Inhaler in Patients with Chronic Obstructive Pulmonary Disease , 2009, Drugs.

[21]  S. Rennard,et al.  Efficacy and Safety of Budesonide and Formoterol in One Pressurized Metered-Dose Inhaler in Patients with Moderate to Very Severe Chronic Obstructive Pulmonary Disease , 2008, Drugs.

[22]  J. L. Izquierdo Alonso,et al.  The excessive use of inhaled corticosteroids in chronic obstructive pulmonary disease. , 2012, Archivos de bronconeumologia.

[23]  B. Nordestgaard,et al.  Myocardial infarction and other co-morbidities in patients with chronic obstructive pulmonary disease: a Danish nationwide study of 7.4 million individuals. , 2011, European heart journal.

[24]  J. Wedzicha,et al.  Controversies in treatment of chronic obstructive pulmonary disease , 2011, The Lancet.

[25]  Meilan K. Han,et al.  Pharmacotherapeutic approaches to preventing acute exacerbations of chronic obstructive pulmonary disease. , 2011, Proceedings of the American Thoracic Society.

[26]  R. Cavallazzi,et al.  Risk of fractures with inhaled corticosteroids in COPD: systematic review and meta-analysis of randomised controlled trials and observational studies , 2011, Thorax.

[27]  R. Jiménez-García,et al.  Inappropriate Overuse of Inhaled Corticosteroids for COPD Patients: Impact on Health Costs and Health Status , 2011, Lung.

[28]  N. Seleno Prevalence of Major Comorbidities in Subjects with COPD and Incidence of Myocardial Infarction and Stroke: a Comprehensive Analysis Using Data from Primary Care , 2011 .

[29]  P. Frith,et al.  Continuous monitoring of circadian glycemic patterns in patients receiving prednisolone for COPD. , 2011, The Journal of clinical endocrinology and metabolism.

[30]  S. Field Roflumilast, a Novel Phosphodiesterase 4 Inhibitor, for COPD Patients with a History of Exacerbations , 2011, Clinical medicine insights. Circulatory, respiratory and pulmonary medicine.

[31]  S. Suissa,et al.  Inhaled corticosteroids and the risks of diabetes onset and progression. , 2010, The American journal of medicine.

[32]  Mario Cazzola,et al.  Prevalence of Comorbidities in Patients with Chronic Obstructive Pulmonary Disease , 2010, Respiration.

[33]  M. Weatherall,et al.  Dose–response relationship of inhaled corticosteroids and cataracts: A systematic review and meta‐analysis , 2009, Respirology.

[34]  D. Postma,et al.  Inhaled corticosteroids in COPD: a case in favour , 2009, European Respiratory Journal.

[35]  S. Suissa,et al.  Inhaled corticosteroids in COPD: the case against , 2009, European Respiratory Journal.

[36]  W. Kuschner,et al.  The Effect of an Inhaled Corticosteroid on Glucose Control in Type 2 Diabetes , 2009, Clinical Medicine & Research.

[37]  D. Au,et al.  The association of inhaled corticosteroid use with serum glucose concentration in a large cohort. , 2009, The American journal of medicine.

[38]  A. Anzueto,et al.  Effect of Fluticasone Propionate/Salmeterol (250/50) on COPD Exacerbations and Impact on Patient Outcomes , 2009, COPD.

[39]  D. Mannino,et al.  Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD , 2008, European Respiratory Journal.

[40]  D. Schoenfeld,et al.  Translating the A1C Assay Into Estimated Average Glucose Values , 2008, Diabetes Care.

[41]  A. Anzueto,et al.  Effect of fluticasone propionate/salmeterol (250/50 microg) or salmeterol (50 microg) on COPD exacerbations. , 2008, Respiratory medicine.

[42]  T. Seemungal,et al.  The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol/fluticasone propionate or tiotropium bromide. , 2008, American journal of respiratory and critical care medicine.

[43]  R. Nave,et al.  The role of esterases in the metabolism of ciclesonide to desisobutyryl-ciclesonide in human tissue. , 2007, Biochemical pharmacology.

[44]  G. Can,et al.  Effects of inhaled budesonide on insulin sensitivity in nondiabetic patients with asthma and chronic obstructive pulmonary disease , 2007, Advances in therapy.

[45]  Bartolome Celli,et al.  Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. , 2007, The New England journal of medicine.

[46]  C. Vogelmeier,et al.  Impact of salmeterol/fluticasone propionate versus salmeterol on exacerbations in severe chronic obstructive pulmonary disease. , 2007, American journal of respiratory and critical care medicine.

[47]  H. Derendorf,et al.  Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma , 2006, European Respiratory Journal.

[48]  K. Lohr,et al.  Efficacy and Safety of Inhaled Corticosteroids in Patients With COPD: A Systematic Review and Meta-Analysis of Health Outcomes , 2006, The Annals of Family Medicine.

[49]  C. Lenfant,et al.  Global Initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease , 2006 .

[50]  Richard J Martin,et al.  Fluticasone propionate plasma concentration and systemic effect: effect of delivery device and duration of administration. , 2005, The Journal of allergy and clinical immunology.

[51]  JoAnn E Manson,et al.  Chronic obstructive pulmonary disease, asthma, and risk of type 2 diabetes in women. , 2004, Diabetes care.

[52]  K. Renton Cytochrome P450 regulation and drug biotransformation during inflammation and infection. , 2004, Current drug metabolism.

[53]  P. Calverley,et al.  Maintenance therapy with budesonide and formoterol in chronicobstructive pulmonary disease , 2003, European Respiratory Journal.

[54]  Emiel F M Wouters,et al.  Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. , 2003, Chest.

[55]  A. Woodcock,et al.  Pharmacokinetics and systemic effects of inhaled fluticasone propionate in chronic obstructive pulmonary disease. , 2003, British journal of clinical pharmacology.

[56]  A. Tattersfield,et al.  Plasma concentrations of fluticasone propionate and budesonide following inhalation from dry powder inhalers by healthy and asthmatic subjects , 2003, Thorax.

[57]  G. Cuda,et al.  Molecular mechanisms of corticosteroid actions in chronic inflammatory airway diseases. , 2003, Life sciences.

[58]  R. Pauwels,et al.  Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial , 2003, The Lancet.

[59]  R. Sansores,et al.  Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease , 2003, European Respiratory Journal.

[60]  J. Hux,et al.  Quantification of the risk of corticosteroid-induced diabetes mellitus among the elderly , 2002, Journal of general internal medicine.

[61]  N. Dendukuri,et al.  Inhaled corticosteroids and the risk of diabetes among the elderly. , 2002, British journal of clinical pharmacology.

[62]  H. Derendorf,et al.  Systemic bioavailability of inhaled steroids: the importance of appropriate and comparable methodology. , 2001, The European respiratory journal.

[63]  J. Connett,et al.  Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmonary disease. , 2000, The New England journal of medicine.

[64]  A. Miller-Larsson,et al.  Prolonged airway activity and improved selectivity of budesonide possibly due to esterification. , 2000, American journal of respiratory and critical care medicine.

[65]  C. Minto,et al.  Pharmacokinetics of epimeric budesonide and fluticasone propionate after repeat dose inhalation--intersubject variability in systemic absorption from the lung. , 2000, British journal of clinical pharmacology.

[66]  D. Niewoehner,et al.  Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. Department of Veterans Affairs Cooperative Study Group. , 1999, The New England journal of medicine.

[67]  M. Dahlbäck,et al.  Reversible fatty acid conjugation of budesonide. Novel mechanism for prolonged retention of topically applied steroid in airway tissue. , 1998, Drug metabolism and disposition: the biological fate of chemicals.

[68]  B. Meibohm,et al.  Pharmacokinetics and pharmacodynamics of inhaled corticosteroids. , 1998, The Journal of allergy and clinical immunology.

[69]  H. Derendorf Pharmacokinetic and pharmacodynamic properties of inhaled corticosteroids in relation to efficacy and safety. , 1997, Respiratory medicine.

[70]  P. Ebden,et al.  The effects of high dose inhaled beclomethasone dipropionate on glucose and lipid profiles in normal and diet controlled diabetic subjects. , 1989, Respiratory medicine.