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The association between inhaled corticosteroid and pneumonia in COPD patients: the improvement of patients' life quality with COPD in Taiwan (IMPACT) study.
Int J Chron Obstruct Pulmon Dis. 2016; 11:2775-2783.IJ

Abstract

To investigate the association between inhaled corticosteroid (ICS) exposure patterns and the risk of pneumonia in chronic obstructive pulmonary disease (COPD) patients, we performed a nested case-control study. Between 1998 and 2010, 51,739 patients, including 19,838 cases of pneumonia, were matched to 74,849 control subjects selected from a cohort of COPD patients using ICSs via risk-set sampling of the database constructed by the National Health Research Institutes of Taiwan. After adjusting for covariates, the current use of ICSs was associated with a 25% increase in the risk of pneumonia (odds ratio [OR] =1.25, 95% confidence interval [CI] =1.20-1.30), and there was an increase in the OR with increase in the average daily dosage. Additionally, users of fluticasone/salmeterol, fluticasone, and either fluticasone/salmeterol or fluticasone were more likely to be at a higher risk of pneumonia (OR =1.35, 95% CI =1.28-1.41; OR =1.22, 95% CI =1.10-1.35; and OR =1.33, 95% CI =1.27-1.39, respectively). In contrast, there were no statistically significant associations between the risk of pneumonia and the use of budesonide/formoterol, budesonide, or either budesonide/formoterol or budesonide. In conclusion, ICSs are significantly associated with an increased risk of pneumonia in COPD patients. The effect is prominent for fluticasone-containing ICSs but not for budesonide-containing ICSs.

Authors+Show Affiliations

Department of Internal Medicine; Medical Research Center, Cardinal Tien Hospital, Fu Jen Catholic University College of Medicine, New Taipei City.Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying.Institute of Population Health Sciences, National Health Research Institutes, Zhunan.Department of Internal Medicine; Medical Research Center, Cardinal Tien Hospital, Fu Jen Catholic University College of Medicine, New Taipei City.Institute of Population Health Sciences, National Health Research Institutes, Zhunan.Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27877031

Citation

Wang, Cheng-Yi, et al. "The Association Between Inhaled Corticosteroid and Pneumonia in COPD Patients: the Improvement of Patients' Life Quality With COPD in Taiwan (IMPACT) Study." International Journal of Chronic Obstructive Pulmonary Disease, vol. 11, 2016, pp. 2775-2783.
Wang CY, Lai CC, Yang WC, et al. The association between inhaled corticosteroid and pneumonia in COPD patients: the improvement of patients' life quality with COPD in Taiwan (IMPACT) study. Int J Chron Obstruct Pulmon Dis. 2016;11:2775-2783.
Wang, C. Y., Lai, C. C., Yang, W. C., Lin, C. C., Chen, L., Wang, H. C., & Yu, C. J. (2016). The association between inhaled corticosteroid and pneumonia in COPD patients: the improvement of patients' life quality with COPD in Taiwan (IMPACT) study. International Journal of Chronic Obstructive Pulmonary Disease, 11, 2775-2783.
Wang CY, et al. The Association Between Inhaled Corticosteroid and Pneumonia in COPD Patients: the Improvement of Patients' Life Quality With COPD in Taiwan (IMPACT) Study. Int J Chron Obstruct Pulmon Dis. 2016;11:2775-2783. PubMed PMID: 27877031.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between inhaled corticosteroid and pneumonia in COPD patients: the improvement of patients' life quality with COPD in Taiwan (IMPACT) study. AU - Wang,Cheng-Yi, AU - Lai,Chih-Cheng, AU - Yang,Wei-Chih, AU - Lin,Chia-Chieh, AU - Chen,Likwang, AU - Wang,Hao-Chien, AU - Yu,Chong-Jen, Y1 - 2016/11/08/ PY - 2016/11/24/entrez PY - 2016/11/24/pubmed PY - 2017/8/15/medline KW - chronic obstructive pulmonary disease KW - inhaled corticosteroid KW - pneumonia SP - 2775 EP - 2783 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 11 N2 - To investigate the association between inhaled corticosteroid (ICS) exposure patterns and the risk of pneumonia in chronic obstructive pulmonary disease (COPD) patients, we performed a nested case-control study. Between 1998 and 2010, 51,739 patients, including 19,838 cases of pneumonia, were matched to 74,849 control subjects selected from a cohort of COPD patients using ICSs via risk-set sampling of the database constructed by the National Health Research Institutes of Taiwan. After adjusting for covariates, the current use of ICSs was associated with a 25% increase in the risk of pneumonia (odds ratio [OR] =1.25, 95% confidence interval [CI] =1.20-1.30), and there was an increase in the OR with increase in the average daily dosage. Additionally, users of fluticasone/salmeterol, fluticasone, and either fluticasone/salmeterol or fluticasone were more likely to be at a higher risk of pneumonia (OR =1.35, 95% CI =1.28-1.41; OR =1.22, 95% CI =1.10-1.35; and OR =1.33, 95% CI =1.27-1.39, respectively). In contrast, there were no statistically significant associations between the risk of pneumonia and the use of budesonide/formoterol, budesonide, or either budesonide/formoterol or budesonide. In conclusion, ICSs are significantly associated with an increased risk of pneumonia in COPD patients. The effect is prominent for fluticasone-containing ICSs but not for budesonide-containing ICSs. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/27877031/The_association_between_inhaled_corticosteroid_and_pneumonia_in_COPD_patients:_the_improvement_of_patients'_life_quality_with_COPD_in_Taiwan__IMPACT__study_ L2 - https://dx.doi.org/10.2147/COPD.S116750 DB - PRIME DP - Unbound Medicine ER -