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Inhaled Long-acting Anticholinergics and Urinary Tract Infection in Individuals with COPD
- Publication Year :
- 2016
- Publisher :
- Taylor & Francis, 2016.
-
Abstract
- Inhaled, long-acting anticholinergic medication (LAA), commonly used for moderate-to-severe chronic obstructive pulmonary disease (COPD), has been shown to decrease COPD hospitalizations, emergency department visits, and acute exacerbations but has also been associated with urinary tract infection (UTI) in a prior meta-analysis. The objective of this study was to verify if there was an association between LAA and UTI in older individuals with COPD. A population-based, real-world cohort study using health administrative data from Ontario, Canada was conducted. Incidence of UTI was compared between older people with physician-diagnosed COPD, who were new users of inhaled long-acting anticholinergics and new users of inhaled corticosteroids–a reference medication used in similar clinical settings that has no known association with UTI. Propensity score matching was used to minimize the effects of confounding. An overall association between LAA and various measures of UTI in older individuals was not found. However, in a priori defined stratified analyses, men newly initiated on LAA were 75% more likely to develop a UTI than men newly started on an inhaled corticosteroid (hazard ratio 1.75; 95% confidence interval 1.05–2.92). No significant association was seen in women. In conclusion, older men with COPD newly started on LAA are at increased risk of UTI. Men considering an inhaled LAA should be informed of this risk and, if they decide to take it, be provided with appropriate monitoring.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.drug_class
030204 cardiovascular system & hematology
urologic and male genital diseases
Cholinergic Antagonists
Cohort Studies
Pulmonary Disease, Chronic Obstructive
03 medical and health sciences
Sex Factors
0302 clinical medicine
Adrenal Cortex Hormones
Risk Factors
Internal medicine
Administration, Inhalation
Anticholinergic
Humans
Medicine
030212 general & internal medicine
Propensity Score
Intensive care medicine
Adverse effect
Aged
Aged, 80 and over
Ontario
COPD
business.industry
Incidence
Incidence (epidemiology)
Hazard ratio
Age Factors
Emergency department
medicine.disease
Delayed-Action Preparations
Urinary Tract Infections
Propensity score matching
Female
business
Cohort study
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....eeb6f9ec16714e2f2b5976b5b633c195
- Full Text :
- https://doi.org/10.6084/m9.figshare.4012317.v1