The association between inhaled corticosteroid and pneumonia in COPD patients: the improvement of patients? life quality with COPD in Taiwan (IMPACT) study Received 8 July 2016
Accepted for publication 26 September 2016
Published 8 November 2016
Volume 2016:11(1) Pages 2775?2783
DOI https://doi.org/10.2147/COPD.S116750
Abstract: To investigate the association between inhaled corticosteroid (ICS) exposure patterns and the risk of pneumonia in chronic obstructive pulmonary disease (COPD) patients, we performed a nested case-control study. Between 1998 and 2010, 51,739 patients, including 19,838 cases of pneumonia, were matched to 74,849 control subjects selected from a cohort of COPD patients using ICSs via risk-set sampling of the database constructed by the National Health Research Institutes of Taiwan. After adjusting for covariates, the current use of ICSs was associated with a 25% increase in the risk of pneumonia (odds ratio [OR] =1.25, 95% confidence interval [CI] =1.20?1.30), and there was an increase in the OR with increase in the average daily dosage. Additionally, users of fluticasone/salmeterol, fluticasone, and either fluticasone/salmeterol or fluticasone were more likely to be at a higher risk of pneumonia (OR =1.35, 95% CI =1.28?1.41; OR =1.22, 95% CI =1.10?1.35; and OR =1.33, 95% CI =1.27?1.39, respectively). In contrast, there were no statistically significant associations between the risk of pneumonia and the use of budesonide/formoterol, budesonide, or either budesonide/formoterol or budesonide. In conclusion, ICSs are significantly associated with an increased risk of pneumonia in COPD patients.
The effect is prominent for fluticasone-containing ICSs but not for budesonide-containing ICSs.
