Journal
PRIMARY CARE RESPIRATORY JOURNAL
Volume 19, Issue 2, Pages 109-117Publisher
PRIMARY CARE RESPIRATORY SOC-PCRS UK
DOI: 10.4104/pcrj.2009.00072
Keywords
COPD; pneumonia; corticosteroids; beta-agonists
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Funding
- GlaxoSmithKline
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Aim: To assess the risk of pneumonia among COPD patients using salmeterol/fluticasone propionate combination inhalers (SFC), inhaled corticosteroids (ICS), or long-acting beta-agonists (LABA), alone or in combination, compared to those using only short-acting bronchodilators (SABD). Method: The study population comprised 5245 individuals using inhaled treatment for COPD, identified from the databases of three large regional managed care organisations from different parts of the USA. Longitudinally-collected administrative data were obtained on their clinical histories and treatments. Nested case-control methods were used to calculate adjusted odds ratios (OR) for the risk of pneumonia while on therapy. Results: 2154 patients had at least one diagnosed case of pneumonia between 1st September 2001 and 31st August 2003. Relative to SABD, the only treatment associated with a non-significant increased risk of pneumonia was ICS used alone (OR=1.29; 95%CI: 0.96-1.73; p=0.09). Users of LABA alone (OR=0.92; 95 /0CI: 0.69-1.22) or SFC (OR=1.03; 95%CI: 0.74-1.42) had no increased risk for pneumonia relative to SABD. Advanced age and severity of lung disease were strongly associated with increased risk for pneumonia. Conclusion: Treatment with ICS or an ICS/LABA combination inhaler was not associated with a significantly increased risk of developing pneumonia. 2010 Primary Care Respiratory Society UK. All rights reserved. D Mapel et al. Prim Care Resp J 2010; 19(2): 109-117 doi:10.4104/pcrj.2009.00072
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