dc.contributor
Institut Català de la Salut
dc.contributor
[Bonnesen B, Eklöf J] Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. [Biering-Sørensen T, Modin D] Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. [Mathioudakis AG] North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. Division of Immunology, Immunity to Infection and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Bonnesen, Barbara
dc.contributor.author
Eklöf, Josefin
dc.contributor.author
Biering-Sørensen, Tor
dc.contributor.author
Modin, Daniel
dc.contributor.author
Mathioudakis, Alexander G
dc.contributor.author
Miravitlles, Marc
dc.date.accessioned
2024-11-01T02:54:35Z
dc.date.available
2024-11-01T02:54:35Z
dc.date.issued
2024-10-31T11:31:39Z
dc.date.issued
2024-10-31T11:31:39Z
dc.date.issued
2024-09-12
dc.identifier
Bonnesen B, Eklöf J, Biering-Sørensen T, Modin D, Miravitlles M, Mathioudakis AG, et al. Effect of low climate impact vs. high climate impact inhalers for patients with asthma and COPD-a nationwide cohort analysis. Respir Res. 2024 Sep 12;25:339.
dc.identifier
https://hdl.handle.net/11351/12165
dc.identifier
10.1186/s12931-024-02942-8
dc.identifier
001310881300001
dc.identifier.uri
http://hdl.handle.net/11351/12165
dc.description.abstract
Asthma; Climate impact; Pneumonia
dc.description.abstract
Asma; Impacte climàtic; Pneumònia
dc.description.abstract
Asma; Impacto climático; Neumonía
dc.description.abstract
Background
Chronic obstructive pulmonary disease (COPD) and asthma can be treated with inhaled corticosteroids (ICS) delivered by low climate impact inhalers (dry powder inhalers) or high climate impact inhalers (pressurized metered-dose inhalers containing potent greenhouse gasses). ICS delivered with greenhouse gasses is prescribed ubiquitously and frequent despite limited evidence of superior effect. Our aim was to examine the beneficial and harmful events of ICS delivered by low and high climate impact inhalers in patients with asthma and COPD.
Methods
Nationwide retrospective cohort study of Danish outpatients with asthma and COPD treated with ICS delivered by low and high climate impact inhalers. Patients were propensity score matched by the following variables; age, gender, tobacco exposure, exacerbations, dyspnoea, body mass index, pulmonary function, ICS dose and entry year. The primary outcome was a composite of hospitalisation with exacerbations and all-cause mortality analysed by Cox proportional hazards regression.
Results
Of the 10,947 patients with asthma and COPD who collected ICS by low or high climate impact inhalers, 2,535 + 2,535 patients were propensity score matched to form the population for the primary analysis. We found no association between high climate impact inhalers and risk of exacerbations requiring hospitalization and all-cause mortality (HR 1.02, CI 0.92–1.12, p = 0.77), nor on pneumonia, exacerbations requiring hospitalization, all-cause mortality, or all-cause admissions. Delivery with high climate impact inhalers was associated with a slightly increased risk of exacerbations not requiring hospitalization (HR 1.10, CI 1.01–1.21, p = 0.03). Even with low lung function there was no sign of a superior effect of high climate impact inhalers.
Conclusion
Low climate impact inhalers were not inferior to high climate impact inhalers for any risk analysed in patients with asthma and COPD.
dc.description.abstract
This study was funded by the Novo Nordisk Foundation (No. NNF20OC0060657). Open access funding provided by Copenhagen University
dc.format
application/pdf
dc.relation
Respiratory Research;25
dc.relation
https://doi.org/10.1186/s12931-024-02942-8
dc.rights
Attribution 4.0 International
dc.rights
http://creativecommons.org/licenses/by/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Pulmons - Malalties obstructives - Tractament
dc.subject
Teràpia respiratòria
dc.subject
Corticosteroides - Ús terapèutic
dc.subject
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drug Therapy::Drug Administration Routes::Administration, Inhalation
dc.subject
CHEMICALS AND DRUGS::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones
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DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
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Other subheadings::Other subheadings::Other subheadings::/drug therapy
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::farmacoterapia::vías de administración de medicamentos::administración por inhalación
dc.subject
COMPUESTOS QUÍMICOS Y DROGAS::hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal
dc.subject
ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica
dc.subject
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
dc.title
Effect of low climate impact vs. high climate impact inhalers for patients with asthma and COPD-a nationwide cohort analysis
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
