Tags

Type your tag names separated by a space and hit enter

Effects of inhaled corticosteroids in monotherapy or combined with long-acting {beta}2-agonists on mortality among patients with chronic obstructive pulmonary disease.
Ann Pharmacother. 2010 Apr; 44(4):613-22.AP

Abstract

BACKGROUND

The benefits of inhaled corticosteroids (ICS) in reducing the mortality related to chronic obstructive pulmonary disease (COPD) are controversial.

OBJECTIVE

To estimate whether ICS in monotherapy or in combination with long-acting beta(2)-agonists (LABA) reduces the mortality rate among COPD patients compared to those treated with LABA monotherapy.

METHODS

Using data from the Canadian province of Quebec's health administrative databases, a nested case-control study was conducted. A cohort of COPD patients aged 50 years and over between 1996 and 2000 was initially formed. Patients were included if they filled at least 6 prescriptions of an inhaled bronchodilator, received at least 1 medical service for COPD, and did not receive any diagnosis of asthma over a 12-month period. For each case of death identified in the cohort, up to 37 controls were time matched. For cases and controls, the exposure to ICS and LABA was assessed within the 3 months prior to the date of death for cases and date of selection for controls. Adjusted mortality rate ratios were estimated by conditional logistic regression comparing patients using ICS monotherapy or ICS/LABA combination therapy with patients using LABA monotherapy.

RESULTS

This study included 5996 cases of death and 54,750 controls. The mortality rates were found to be lower among users of ICS monotherapy than users of LABA monotherapy (OR 0.69; 95% CI 0.53 to 0.88) and lower among users of an ICS/LABA combination than users of LABA monotherapy (OR 0.73; 95% CI 0.56 to 0.96). No significant differences were observed between users of ICS/LABA combination therapy and users of ICS monotherapy (OR 1.07; 95% CI 0.93 to 1.23).

CONCLUSIONS

ICS were found to be associated with a reduction in mortality rate when compared to LABA among patients with COPD. However, the ICS/LABA combination therapy did not provide any additional benefit on mortality when compared to ICS monotherapy.

Authors+Show Affiliations

Université de Montréal, Québec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20233915

Citation

Cyr, Marie-Christyne, et al. "Effects of Inhaled Corticosteroids in Monotherapy or Combined With Long-acting {beta}2-agonists On Mortality Among Patients With Chronic Obstructive Pulmonary Disease." The Annals of Pharmacotherapy, vol. 44, no. 4, 2010, pp. 613-22.
Cyr MC, Beauchesne MF, Lemière C, et al. Effects of inhaled corticosteroids in monotherapy or combined with long-acting {beta}2-agonists on mortality among patients with chronic obstructive pulmonary disease. Ann Pharmacother. 2010;44(4):613-22.
Cyr, M. C., Beauchesne, M. F., Lemière, C., Aaron, S. D., & Blais, L. (2010). Effects of inhaled corticosteroids in monotherapy or combined with long-acting {beta}2-agonists on mortality among patients with chronic obstructive pulmonary disease. The Annals of Pharmacotherapy, 44(4), 613-22. https://doi.org/10.1345/aph.1M243
Cyr MC, et al. Effects of Inhaled Corticosteroids in Monotherapy or Combined With Long-acting {beta}2-agonists On Mortality Among Patients With Chronic Obstructive Pulmonary Disease. Ann Pharmacother. 2010;44(4):613-22. PubMed PMID: 20233915.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of inhaled corticosteroids in monotherapy or combined with long-acting {beta}2-agonists on mortality among patients with chronic obstructive pulmonary disease. AU - Cyr,Marie-Christyne, AU - Beauchesne,Marie-France, AU - Lemière,Catherine, AU - Aaron,Shawn D, AU - Blais,Lucie, Y1 - 2010/03/16/ PY - 2010/3/18/entrez PY - 2010/3/18/pubmed PY - 2010/6/16/medline SP - 613 EP - 22 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 44 IS - 4 N2 - BACKGROUND: The benefits of inhaled corticosteroids (ICS) in reducing the mortality related to chronic obstructive pulmonary disease (COPD) are controversial. OBJECTIVE: To estimate whether ICS in monotherapy or in combination with long-acting beta(2)-agonists (LABA) reduces the mortality rate among COPD patients compared to those treated with LABA monotherapy. METHODS: Using data from the Canadian province of Quebec's health administrative databases, a nested case-control study was conducted. A cohort of COPD patients aged 50 years and over between 1996 and 2000 was initially formed. Patients were included if they filled at least 6 prescriptions of an inhaled bronchodilator, received at least 1 medical service for COPD, and did not receive any diagnosis of asthma over a 12-month period. For each case of death identified in the cohort, up to 37 controls were time matched. For cases and controls, the exposure to ICS and LABA was assessed within the 3 months prior to the date of death for cases and date of selection for controls. Adjusted mortality rate ratios were estimated by conditional logistic regression comparing patients using ICS monotherapy or ICS/LABA combination therapy with patients using LABA monotherapy. RESULTS: This study included 5996 cases of death and 54,750 controls. The mortality rates were found to be lower among users of ICS monotherapy than users of LABA monotherapy (OR 0.69; 95% CI 0.53 to 0.88) and lower among users of an ICS/LABA combination than users of LABA monotherapy (OR 0.73; 95% CI 0.56 to 0.96). No significant differences were observed between users of ICS/LABA combination therapy and users of ICS monotherapy (OR 1.07; 95% CI 0.93 to 1.23). CONCLUSIONS: ICS were found to be associated with a reduction in mortality rate when compared to LABA among patients with COPD. However, the ICS/LABA combination therapy did not provide any additional benefit on mortality when compared to ICS monotherapy. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/20233915/Effects_of_inhaled_corticosteroids_in_monotherapy_or_combined_with_long_acting_{beta}2_agonists_on_mortality_among_patients_with_chronic_obstructive_pulmonary_disease_ L2 - https://journals.sagepub.com/doi/10.1345/aph.1M243?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -