Combination therapy of inhaled corticosteroids and long-acting beta2 -agonists may be associated with risk reduction of lung cancer in COPD patients who quit smoking
V. A. Kiri, L. M. Fabbri, K. J. Davis, J. B. Soriano (Greenford, United Kingdom; Modena, Italy; Research Triangle Park, United States Of America; Mallorca, Spain)
Source: Annual Congress 2006 - Epidemiological aspects of lung tumors and infections including tuberculosis
Disease area: Airway diseases
Abstract Introduction: There is a strong association between COPD and lung cancer occurrence. Inflammation is a recognised feature of both diseases. Growing evidence indicates inhaled corticosteroids (ICS) and long acting beta2 -agonists (LABA) improve several outcomes of COPD in epidemiological studies. We explored the possible role of ICS combined with LABA (i.e. ICSLABA) in preventing or delaying lung cancer occurrence in COPD patients. Methods: All COPD patients diagnosed between 1998-2003 in the UK General Practice Research Database, who subsequently quit smoking and with 3 or more prescriptions of either ICS with/without LABA or short-acting bronchodilators (SABA) within the first six months of smoking cessation constituted our cohort. Those who later developed lung cancer (i.e. cases) were each matched to as many non-cases of the same age, gender and COPD duration as were available. We used conditional logistic regression to obtain adjusted hazard ratios controlling for comorbidities and prior drug use. Results: We matched 118 incident cases to 468 non-cases- of which 268 used ICSLABA, 204 used ICS without LABA (i.e. ICS-only), and 114 used SABA only. Lung cancer was diagnosed in 16.4% of ICSLABA users, in 20.1% of ICS-only users and in 29.0% of those who used SABA only. In multivariate analyses, a significant association of lower lung cancer risk of about 60% (p<0.002) in ICSLABA users and 49% (p<0.03) in ICS-only users were observed when compared to users of SABA only. Conclusions: In ex-smokers with COPD, regular use of ICS, particularly combined with LABA, may be associated with a reduced risk of lung cancer.
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V. A. Kiri, L. M. Fabbri, K. J. Davis, J. B. Soriano (Greenford, United Kingdom; Modena, Italy; Research Triangle Park, United States Of America; Mallorca, Spain). Combination therapy of inhaled corticosteroids and long-acting beta2 -agonists may be associated with risk reduction of lung cancer in COPD patients who quit smoking. Eur Respir J 2006; 28: Suppl. 50, 2637
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