Kortikosteroid Inhalasi dan Risiko Reaktivasi TB

Oleh :

dr. Reren Ramanda

Kortikosteroid inhalasi adalah obat yang sangat efektif dalam menekan proses inflamasi dan reaksi hiperresponsif imunitas pada tubuh manusia. Penggunaan kortikosteroid inhalasi umum diberikan untuk meredakan reaksi inflamasi pada penyakit saluran napas kronik, seperti asma dan penyakit paru obstruktif kronis.[1-3]

Pemberian kortikosteroid inhalasi pada kasus asma dan penyakit paru obstruktif kronis (PPOK) terutama sebagai modalitas preventif kejadian eksaserbasi. Kortikosteroid inhalasi dan kombinasi dengan long acting beta agonist (LABA) sudah menjadi tata laksana rutin sesuai dengan GINA 2021. Penggunaan kortikosteroid inhalasi terbukti secara signifikan menurunkan kebutuhan steroid peroral pada pasien penyakit saluran napas kronik.[3-6]

Efek Samping Kortikosteroid Inhalasi

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Referensi

1. Lee, CH. et al. Use of inhaled corticosteroids and the risk of tuberculosis. Thorax 2013;68:1105–1113. https://thorax.bmj.com/content/thoraxjnl/68/12/1105.full.pdf
2. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. 2022. https://goldcopd.org/2022-gold-reports-2/
3. Liang, TZ. and Chao, JH. Inhaled Corticosteroids. Statpearl. 2021. https://www.ncbi.nlm.nih.gov/books/NBK470556/
4. Miravitlles, M. et al. Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD. European Respiratory Review 2021 30: 210075. https://err.ersjournals.com/content/30/160/210075.long
5. Pandya D, Puttanna A, Balagopal V. Systemic effects of inhaled corticosteroids: an overview. Open Respir Med J. 2014;8:59-65. Published 2014 Dec 31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319197/
6. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2022. https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf
7.Kementerian Kesehatan RI. Petunjuk Teknis Penanganan Infeksi Laten Tuberkulosis. 2020. https://tbindonesia.or.id/wp-content/uploads/2021/01/Isi-Juknis-ILTB-FINAL-ok_published.pdf
8. Ni, S. Fu, Z. et al. Inhaled corticosteroids (ICS) and risk of mycobacterium in patients with chronic respiratory diseases: a meta-analysis. J Thorac Dis 2014;6(7):971-978. https://jtd.amegroups.com/article/view/2791/3314
9. Chung, WS. Et al. Inhaled corticosteroids and the increased risk of pulmonary tuberculosis: a population-based case–control study. Int J Clin Pract, October 2014, 68, 10, 1193–1199. https://image.cse.nsysu.edu.tw/ServerPaper/1000/2014-08-Inhaled%20Corticosteroids%20and%20the%20Increased%20Risk%20of%20Pulmonary%20Tuberculosis%20A%20Population-based%20Case%20Control%20Study.pdf
10. Castellana, G. Castellana, M. and Castellana C. et al. Inhaled Corticosteroids And Risk Of Tuberculosis In Patients With Obstructive Lung Diseases: A Systematic Review And Meta-Analysis Of Non-randomized Studies. Int J Chron ObstructPulmon Dis. 2019;14:2219-2227. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769028/
11. Huang, TM. Et al. Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids. BMC Infect Dis 20, 706 (2020). https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05440-6
12. Lee,CM. et al. Inhaled Corticosteroid-Related Tuberculosis in the Real World Among Patients with Asthma and COPD: A 10-Year Nationwide Population-Based Study. Journal of Allergy and Clinical Immunology. Volume 7, Issue 4, P1197-1206.E3, April 01, 2019. https://www.jaci-inpractice.org/article/S2213-2198(18)30664-0/pdf
13. Venkitakrishnan, R. et al. Inhaled corticosteroids and risk of tuberculosis—How bad is the risk?, Indian Journal of Tuberculosis, Volume 69, Issue 2, 2022, Pages 128-130. https://www.sciencedirect.com/science/article/abs/pii/S0019570721001153