Abstract
Background/Aims: In recently published randomized clinical trials, COPD patients using inhaled corticosteroids (ICS) alone or in combination with long-acting beta-agonists (LABA) were found to have a small but significantly increased risk of pneumonia. The purpose of this project was to determine whether general population COPD patients using a combined fluticasone and salmeterol inhaler had a higher risk for pneumonia compared to those using other inhaled ICS or bronchodilators, either alone or in combination.
Methods: COPD patients were identified from three health systems in different regions in the United States. The study population was comprised of 5245 individuals who used some form of inhaled treatment during the study period (September 1, 2000 through August 31, 2003), 2154 of whom had at least one pneumonia episode confirmed by chest X-ray or hospitalization. Nested case-control methods were used to calculate odds ratios (OR) for the risk of pneumonia while on therapy.
Results: With patients using short-acting bronchodilators as the reference group, the only treatment associated with a possibly 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% CI, 0.69–1.22) and fluticasone and salmeterol in combination (OR, 1.03; 95% CI, 0.74–1.42) had no increased risk for pneumonia.
Conclusions: In this retrospective analysis of a large COPD cohort, treatment with any ICS, LABD, or ICS and LABD in combination was not associated with a substantially increased risk for developing pneumonia. Funded By: GlaxoSmithKline Research & Development.
- Received September 11, 2008.
