Patients with chronic obstructive pulmonary disease (COPD) are often prescribed oral corticosteroids (OCSs) if there is a sudden deterioration in their condition. A scholar of the School of Nursing and Health Studies at Hong Kong Metropolitan University (HKMU) and related research team conducted a long-term study that unveils an increased risk of 17 diseases, including cardiovascular disease, associated with OCS use for COPD. The research team recommended exploring alternative treatments to minimise the possible side effects of using OCSs to alleviate the condition.

COPD is one of the most common chronic airway diseases, which leads to chronic inflammation and small airway changes in the lungs, resulting in obstruction of airflow in the patients' airways. According to figures from the World Health Organization, COPD is the third leading cause of global mortality; 3.23 million deaths from COPD were reported in 2019, and the incidence of COPD has continued to escalate. The disease may cause a sudden deterioration in the patient's condition. To manage the sudden deterioration, OCSs are prescribed to address acute exacerbation and help the patient recover. However, the medication has potential adverse outcomes, and the short- and long-term risks are not fully understood by the medical sector.

Since 2021, Prof. Gary Tse, from HKMU's School of Nursing and Health Studies, in collaboration with researchers and scholars from AstraZeneca UK, the University of Ferrara, and the University of Aberdeen, has conducted a study to assess the association between COPD-related OCS exposure and adverse outcomes. By utilising anonymised electronic patient medical records from primary care in England, the research team conducted a follow-up study that spanned 6.9 years for a group of patients who used OCSs and 5.4 years for the group who did not use them. Of the patients included in the study, 33% had not been prescribed OCSs. Each patient taking OCSs was matched with a patient with a similar condition not using OCSs, resulting in a total of 53,299 pairs. The analysis focused on assessing the risks of 17 diseases, such as lung inflammation, osteoporosis and cardiovascular disease, among patients. The work was published in the International Journal of Chronic Obstructive Pulmonary Disease in November 2023.

The research concluded that the patients exposed to OCSs faced a higher risk of 17 diseases and other adverse outcomes, including lung inflammation, osteoporosis, cardiovascular disease, weight gain, chronic kidney disease and death. A higher dosage of OCSs was associated with an increased risk of developing these diseases and other health complications.

Prof. Tse emphasised that the research shed light on the risks of using OCSs in patients with COPD, thereby increasing understanding among medical professionals on the side effects of the medication. He stated, “The use of OCSs elevates the relevant health risks, especially for older patients. We recommend exploring alternative treatments to manage COPD and reduce reliance on OCSs.”