Factorial Analysis of the Onset of Hoarseness, the Side Effect of Inhaled Corticosteroids

Abstract

Recently, use of inhaled corticosteroid anti-asthmatic drugs has been increasing due to the increase of bronchial asthma patients. However, there are some side effects of inhaled corticosteroid, such as hoarseness, which can affect a patient's quality of life (QOL). Therefore, to contribute to the proper and individual use of these anti-asthmatic drugs, we conducted a statistical analysis to determine the cause of hoarseness by collecting information to find a relationship between the rate of patients suffering from hoarseness, their personal backgrounds and each inhaled corticosteroid. In our present study, the rate of hoarseness onset in smokers was 4.15 times higher than that of non-smokers. On the other hand, fluticasone propionate (FP) is the component of inhaled anti-asthmatic drugs, which has the largest average particle size. Rate of hoarseness onset of inhaled FP was higher than any other component of inhaled corticosteroids. However, in inhaled anti-asthmatic drugs having FP as the main corticosteroid component, difference of the onset of hoarseness was observed between five nozzle types of devices. This result suggested that the cause of this difference was derived from the individual shape of the device's nozzle. In this study, it was revealed that the difference in nozzle types of devices and the particle size of drug components affect mainly the occurrence frequency of hoarseness. These results provide helpful information about appropriate use of inhaled anti-asthmatic drugs including effective patient education for self-administration. Key words-inhaled corticosteroid, hoarseness, side effects, anti-asthmatic drug 一 般 論 文 として，気管支の炎症を抑制する薬剤や，収縮し た気管支を拡張させる薬剤が存在する．前者には 吸入ステロイド薬（ inhaled corticosteroid: ICS ）が， 後者には気管支拡張薬（ β2 刺激薬やテオフィリ ン）が主に用いられる．また，ステロイド薬と β2 刺激薬を合剤として使用する吸入薬も存在す る．その他，抗アレルギー薬や減感作療法を用い たり，各個人の体質（証）に合わせた漢方薬を用 いた治療法も行われたりしている．このなかで最