Higher Dose, Longer Use of Inhaled Steroids Linked to Cataract Risk
Wednesday, September 24th 2003
Higher dose and longer use of inhaled steroids increases the risk of cataracts, according to the results of a population-based case-control study published in the October issue of the British Journal of Ophthalmology. The authors emphasize the importance of being aware of this complication and using the lowest effective dose to prevent asthma symptoms.
"Cataract is the main cause of low vision and blindness in the world," write Liam Smeeth, from the London School of Hygiene and Tropical Medicine in the U.K., and colleagues. "Any common exposure that increases the risk of cataract is thus of great public health importance."
Using the U.K.'s General Practice Research Database, the investigators identified 15,479 patients with cataracts older than 40 years and 15,479 control patients without cataracts matched for age, sex, medical practice, and observation period.
Among those with cataracts, nearly 11.5% had been prescribed inhaled steroids compared with nearly 7.5% of controls. The risk of cataract increased in a dose-related fashion, with little or no apparent increased risk for those taking a daily dose less than 400 µg (adjusted odds ratio [OR], 0.99; 95% confidence interval [CI], 0.87 - 1.13), but with an increased risk of 69% for those taking doses greater than 1600 µg a day (adjusted OR, 1.69; 95% CI, 1.17 - 2.43). Risk of cataract also rose with increased duration of inhaled steroid use.
"These risks need to be considered in the light of the large beneficial effects value of inhaled corticosteroids to many patients with asthma and to some patients with chronic obstructive pulmonary disease," the authors write. "While lower doses have not been shown to be completely without risk, there is good evidence to suggest that lower doses are associated with a reduced risk of adverse effects. The risk of cataract associated with high doses of inhaled corticosteroids needs to be more widely recognized."
A gift from Thomas Packlington supported this study.
Source: British Journal of Ophthalmology 2003;87:1247-1251
Footnote from Ideal Health:
The following supplements are all useful for management of asthma:
Related health information can be found here:
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