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Risk of sepsis among patients with COPD treated with fixed combinations of inhaled corticosteroids and long-acting Beta2 agonists.
Aging (Albany NY). 2019 09 10; 11(17):6863-6871.A

Abstract

This study aimed to compare the effect of budesonide/formoterol and fluticasone/salmeterol on the risk and outcomes of sepsis in COPD patients. We conducted this study using the Taiwan National Health Insurance Research Database. We included COPD patients prescribed with budesonide/formoterol or fluticasone/salmeterol between 2004 and 2011. Outcomes including sepsis and mortality were measured. 10,267 COPD patients who received fluticasone/salmeterol and 6,844 patients who received budesonide/formoterol were enrolled into this study and then subsequence were adjusted by propensity score weighting. The incidence of sepsis was 5.74 and 4.99 per 100 person-years for the patients receiving fluticasone/salmeterol and budesonide/formoterol, respectively. Fluticasone/salmeterol was associated with higher risk of sepsis (aHR, 1.15; 95%CI, 1.07-1.24) and septic shock (aHR, 1.14; 95%CI, 1.01-1.29) than budesonide/formoterol. Besides, fluticasone/salmeterol was associated with higher risk of death (aHR, 1.090; 95%CI, 1.01-1.18) than budesonide/formoterol. Patients receiving fluticasone/salmeterol had a significant higher risk of sepsis related respiratory organ dysfunction, lower respiratory tract infection, genitourinary tract infection, bacteremia and skin infection. In conclusion, long-term treatment with budesonide/formoterol was associated with lower rates of sepsis and deaths than fluticasone/salmeterol in patients with COPD.

Authors+Show Affiliations

Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

31509517

Citation

Wang, Cheng-Yi, et al. "Risk of Sepsis Among Patients With COPD Treated With Fixed Combinations of Inhaled Corticosteroids and Long-acting Beta2 Agonists." Aging, vol. 11, no. 17, 2019, pp. 6863-6871.
Wang CY, Lin YS, Wang YH, et al. Risk of sepsis among patients with COPD treated with fixed combinations of inhaled corticosteroids and long-acting Beta2 agonists. Aging (Albany NY). 2019;11(17):6863-6871.
Wang, C. Y., Lin, Y. S., Wang, Y. H., Lai, C. C., Wang, H. C., Chen, L., & Yu, C. J. (2019). Risk of sepsis among patients with COPD treated with fixed combinations of inhaled corticosteroids and long-acting Beta2 agonists. Aging, 11(17), 6863-6871. https://doi.org/10.18632/aging.102217
Wang CY, et al. Risk of Sepsis Among Patients With COPD Treated With Fixed Combinations of Inhaled Corticosteroids and Long-acting Beta2 Agonists. Aging (Albany NY). 2019 09 10;11(17):6863-6871. PubMed PMID: 31509517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of sepsis among patients with COPD treated with fixed combinations of inhaled corticosteroids and long-acting Beta2 agonists. AU - Wang,Cheng-Yi, AU - Lin,You Shuei, AU - Wang,Ya-Hui, AU - Lai,Chih-Cheng, AU - Wang,Hao-Chien, AU - Chen,Likwang, AU - Yu,Chong-Jen, AU - ,, Y1 - 2019/09/10/ PY - 2019/06/12/received PY - 2019/08/14/accepted PY - 2019/9/12/pubmed PY - 2020/9/22/medline PY - 2019/9/12/entrez KW - chronic obstructive pulmonary disease KW - inhaled corticosteroids KW - long-acting beta2 agonists KW - sepsis SP - 6863 EP - 6871 JF - Aging JO - Aging (Albany NY) VL - 11 IS - 17 N2 - This study aimed to compare the effect of budesonide/formoterol and fluticasone/salmeterol on the risk and outcomes of sepsis in COPD patients. We conducted this study using the Taiwan National Health Insurance Research Database. We included COPD patients prescribed with budesonide/formoterol or fluticasone/salmeterol between 2004 and 2011. Outcomes including sepsis and mortality were measured. 10,267 COPD patients who received fluticasone/salmeterol and 6,844 patients who received budesonide/formoterol were enrolled into this study and then subsequence were adjusted by propensity score weighting. The incidence of sepsis was 5.74 and 4.99 per 100 person-years for the patients receiving fluticasone/salmeterol and budesonide/formoterol, respectively. Fluticasone/salmeterol was associated with higher risk of sepsis (aHR, 1.15; 95%CI, 1.07-1.24) and septic shock (aHR, 1.14; 95%CI, 1.01-1.29) than budesonide/formoterol. Besides, fluticasone/salmeterol was associated with higher risk of death (aHR, 1.090; 95%CI, 1.01-1.18) than budesonide/formoterol. Patients receiving fluticasone/salmeterol had a significant higher risk of sepsis related respiratory organ dysfunction, lower respiratory tract infection, genitourinary tract infection, bacteremia and skin infection. In conclusion, long-term treatment with budesonide/formoterol was associated with lower rates of sepsis and deaths than fluticasone/salmeterol in patients with COPD. SN - 1945-4589 UR - https://www.unboundmedicine.com/medline/citation/31509517/Risk_of_sepsis_among_patients_with_COPD_treated_with_fixed_combinations_of_inhaled_corticosteroids_and_long_acting_Beta2_agonists_ L2 - https://www.impactaging.com/full/11/6863 DB - PRIME DP - Unbound Medicine ER -