[Study] Use of steroid inhalers increases risk of NTM in some patients

Posted by sweethighland @sweethighland, Aug 15, 2022

Treating asthma or COPD with steroid inhaler raises the risk of hard-to-treat infections
https://erj.ersjournals.com/press/2109-treating-asthma-or-copd-with-steroid-inhaler

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Profile picture for happy2023 @happy2023

@sueinmn
Sue, I am a patient at NJH. I came across this article:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6494510/
It addresses use of inhaled corticosteroids for bronchiectasis.
Is it wise to ask my pulmonologist about the information in this article?

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@happy2023 What would you ask you ask pulmonologist? The article you cited says, more or less, that it didn't find enough validated studies to form a conclusion that inhaled corticosteroids (ICS) cause a high risk of infection. The article I reviewed here a couple of years ago (https://publications.ersnet.org/content/erj/50/3/1700037) seemed to conclude that ICS use could actually decrease risk of pneumonia. The statistics on how much they increase risk of NTM wasn't clearly addressed.

Are you using a steroid inhaler now?

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I use low dose Symbicort once daily as it is less of a burden than twice daily.
My pulmonologist recommends twice daily. How do I decide?
And what truly is the best option to safeguard lung health?

REPLY
Profile picture for happy2023 @happy2023

I use low dose Symbicort once daily as it is less of a burden than twice daily.
My pulmonologist recommends twice daily. How do I decide?
And what truly is the best option to safeguard lung health?

Jump to this post

@happy2023 When you say "less of a burden" is it because you fear infection? My pulmonologist is adamant that improved lung function = less risk of infection.

Adequately treating asthma, shortness of breath, and inflammation (all of which Symbicort does) is important. Formoterol, the long-acting bronchodilator (LABA), stays in the system for about 12 hours, so twice a day is the recommended interval for optimum therapeutic effect. I am actually encouraged to use mine 3-4 times a day during my peak asthma/allergy times.

Budesonide, the corticosteroid portion of Symbicort, may stay in the body for more than 12 hours, enough has been eliminated to be less than a therapeutic level after 10-12 hours.

Have you had increased infections while using Symbicort?

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