Studies on use of inhaled corticosteroids (ICS) and the risk of nontuberculous mycobacterial lung disease (NTM-LD) are limited and have some conflicting results. We recruited 1235 NTM-LD patients and found that ICS use within 1 year was associated with increased NTM-LD, and the risk increased with elevated ICS dose and cumulative duration. Discontinuation of ICS use for more than 120 days could reduce the risk of NTM-LD to an insignificant level. For NTM species, the development of NTM-LD by ICS was highest for Mycobacterium kansasii lung disease. The pooled results of the meta-analysis showed that ICS use might increase the risk of NTM-LD with dose response in medium and high dose of daily ICS. In addition, budesonide had a smaller impact on the risk of NTM-LD than other ICS medications. The present study and meta-analysis provide evidence for ICS adjustment, including dose, discontinuation effect, and medications to possibly reduce the risk of NTM-LD.

中文翻译：

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吸入皮质类固醇会增加非结核分枝杆菌肺病的风险：一项嵌套病例对照研究和荟萃分析

关于使用吸入性皮质类固醇 (ICS) 和非结核性分枝杆菌肺病 (NTM-LD) 风险的研究是有限的，并且有一些相互矛盾的结果。我们招募了 1235 名 NTM-LD 患者，发现 1 年内使用 ICS 与 NTM-LD 增加相关，并且风险随着 ICS 剂量和累积持续时间的增加而增加。停止使用 ICS 超过 120 天可以将 NTM-LD 的风险降低到微不足道的水平。对于 NTM 物种，ICS 对 NTM-LD 的发展对堪萨斯分枝杆菌肺病最高。荟萃分析的汇总结果表明，ICS 的使用可能会增加 NTM-LD 的风险，并在中高剂量的每日 ICS 中出现剂量反应。此外，布地奈德对 NTM-LD 风险的影响小于其他 ICS 药物。