Volume 19 Issue 2 June 2010Original Research
Pneumonia among COPD patients using inhaled
corticosteroids and long-acting bronchodilators
Pages 109-117
*Douglas Mapela, Michael Schuma, Marianne Yoodb, Jeffrey Brownc, David Millerd, Kourtney Davisd
a
Lovelace Clinic Foundation, Albuquerque, New Mexico, USA
b
Department of Epidemiology & Public Health, Yale University School of Medicine, Hamden, Connecticut, USA
c
Harvard Pilgrim Health Care, Harvard Medical School, Boston, Massachusetts, USA
d
GlaxoSmithKline, Research Triangle Park, North Carolina, USA
Received 18 May 2009 • Accepted 21 October 2009 • Online 15 January 2010
Abstract
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%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.
Keywords
COPD, pneumonia, corticosteroids, beta-agonists
* Corresponding author. Douglas Mapel Tel: 505-938-9900 Fax: 505-938-9940 Email: dmapel@comcast.net | |
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