Dose–response relationship of inhaled corticosteroids and cataracts: A systematic review and meta‐analysis

@article{Weatherall2009DoseresponseRO,
  title={Dose–response relationship of inhaled corticosteroids and cataracts: A systematic review and meta‐analysis},
  author={Mark W Weatherall and Jennifer Clay and Kate James and Kyle Perrin and Philippa Shirtcliffe and Richard Beasley},
  journal={Respirology},
  year={2009},
  volume={14}
}
Background and objective:  The risk of cataracts associated with the long‐term use of inhaled corticosteroids (ICS) is poorly recognized, yet may be of major public health importance. The aim of this study was to determine the dose–response relationship of ICS use and risk of cataracts in adults. 
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There are many adverse effects associated with corticosteroid treatment, which include cataracts, osteoporosis, diabetes mellitus, and delirium, which are more common and more dangerous in the elderly population.
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References

SHOWING 1-10 OF 43 REFERENCES
Dose–response relationship for risk of non‐vertebral fracture with inhaled corticosteroids
  • M. Weatherall, K. James, R. Beasley
  • Medicine
    Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
  • 2008
TLDR
The strength of association between the dose of inhaled corticosteroids (ICS) and risk of non‐vertebral fracture in adults in adults is studied.
A population based case-control study of cataract and inhaled corticosteroids
TLDR
Higher doses and longer duration of exposure to inhaled corticosteroids are associated with an increased risk of cataract, and the lowest doses compatible with good control of airways disease should be used.
Low-dose inhaled and nasal corticosteroid use and the risk of cataracts
TLDR
It is concluded that, among the elderly, even low doses of inhaled corticosteroids are associated with a small but significant excess risk of cataracts requiring extraction, and the increase in risk was apparent even at daily doses of ≤500 μg.
Smoking and cataract: Review of causal association
Use of inhaled corticosteroids and the risk of cataracts.
Association of inhaled corticosteroid use with cataract extraction in elderly patients.
TLDR
Prolonged administration of high doses of inhaled corticosteroids increases the likelihood of undergoing cataract extraction in elderly patients, and the risk of developing cataracts for low to medium doses over longer periods is increased.
The Risk of Cataract among Users of Inhaled Steroids
TLDR
A retrospective observational cohort study of patients identified from the United Kingdom–based General Practice Database with a nested case-control analysis found that among individuals 40 years of age or older, the risk ratio increased with use of increasing numbers of inhaled corticosteroid prescriptions after controlling for diabetes mellitus, hypertension, and smoking history.
Corticosteroids in Ophthalmology: Past – Present – Future
TLDR
This review is intended to summarize some relevant aspects on the use of corticosteroids, their main indications as well as their limitations in ophthalmology.
Corticosteroid-induced cataracts.
Inhaled fluticasone propionate and adrenal effects in adult asthma: systematic review and meta-analysis
TLDR
For routine prescribing within the established therapeutic dose–response range (50–500 μg·day-1), fluticasone propionate has minimal effects on adrenal function.
...
...