Abstract
Aim
To assess the risk of pneumonia among COPD patients using salmeterol/fluticasone-piopionate 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%CI: 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.
Similar content being viewed by others
Article PDF
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
Drs. Mapel, Schum, Yood, and Brown were provided a grant from GlaxoSmithKline to conduct this project. Dr. Mapel has conducted other COPD research projects for GlaxoSmithKline, Pfizer Pharmaceuticals, and Boehringer-Ingelheim, and he has served as a consultant to and speaker for each these companies. Drs. Miller and Davis are employees of GlaxoSmithKline.
Rights and permissions
About this article
Cite this article
Mapel, D., Schum, M., Yood, M. et al. Pneumonia among COPD patients using inhaled corticosteroids and long-acting bronchodilators. Prim Care Respir J 19, 109–117 (2010). https://doi.org/10.4104/pcrj.2009.00072
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.4104/pcrj.2009.00072
This article is cited by
-
Inhaled bronchodilators and acute myocardial infarction: a nested case-control study
Scientific Reports (2017)
-
Comparative effectiveness of budesonide/formoterol combination and fluticasone/salmeterol combination among chronic obstructive pulmonary disease patients new to controller treatment: a US administrative claims database study
Respiratory Research (2015)
-
Management of Asthma and Chronic Obstructive Pulmonary Disease with Combination Inhaled Corticosteroids and Long-Acting β-Agonists: A Review of Comparative Effectiveness Research
Drugs (2014)
