Thiazolidinediones and the risk of asthma exacerbation among patients with diabetes: a cohort study

Allergy, Asthma & Clinical Immunology

Seppo T Rinne⁵  Laura C Feemster⁵  Bridget F Collins⁵  David H Au⁵  Mark Perkins¹  Christopher L Bryson⁴  Thomas G O’Riordan³  Chuan-Fen Liu² 

[1] Health Services Research and Development, VA Puget Sound Health Care System, Department of Veterans Affairs, 1100 Olive Way Suite 1400, 98104-3801 Seattle, WA, USA

[2] Department of Health Services, University of Washington, Seattle, WA, USA

[3] Gilead Sciences, Inc., Seattle, WA, USA

[4] Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA

[5] Department of Pulmonary and Cri Care, University of Washington, Seattle, WA, USA

关键词: Cohort study;    Asthma;    Glitazones;    Peroxisome proliferator-activated receptors;    Thiazolidinediones;   

Others  :  1082144
DOI  :  10.1186/1710-1492-10-34

 received in 2014-01-23, accepted in 2014-06-19,  发布年份 2014

【 摘 要 】

Background

Thiazolidinediones are oral diabetes medications that selectively activate peroxisome proliferator-activated receptor gamma and have potent anti-inflammatory properties. While a few studies have found improvements in pulmonary function with exposure to thiazolidinediones, there are no studies of their impact on asthma exacerbations. Our objective was to assess whether exposure to thiazolidinediones was associated with a decreased risk of asthma exacerbation.

Methods

We performed a cohort study of diabetic Veterans who had a diagnosis of asthma and were taking oral diabetes medications during the period of 10/1/2005 – 9/30/2006. The risk of asthma exacerbations and oral steroid use during 10/1/2006 – 9/30/2007 was compared between patients who were prescribed thiazolidinediones and patients who were on alternative oral diabetes medications. Multivariable logistic regression and negative binomial regression analyses were used to characterize this risk. A sensitivity analysis was performed, restricting our evaluation to patients who were adherent to diabetes therapy.

Results

We identified 2,178 patients who were on thiazolidinediones and 10,700 who were not. Exposure to thiazolidinediones was associated with significant reductions in the risk of asthma exacerbation (OR = 0.79, 95% CI, 0.62 – 0.99) and oral steroid prescription (OR = 0.73, 95% CI 0.63 – 0.84). Among patients who were adherent to diabetes medications, there were more substantial reductions in the risks for asthma exacerbation (OR = 0.64, 95% CI 0.47 – 0.85) and oral steroid prescription (OR = 0.68, 95% CI 0.57 – 0.81).

Conclusions

Thiazolidinediones may provide a novel anti-inflammatory approach to asthma management by preventing exacerbations and decreasing the use of oral steroids.

【 授权许可】

   
2014 Rinne et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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