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Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids.
BMC Infect Dis. 2020 Sep 25; 20(1):706.BI

Abstract

OBJECTIVES

To investigate the incidence of active tuberculosis (TB) among COPD patients using fluticasone/salmeterol or budesonide/formoterol, and to identify any differences between these two groups of patients.

METHODS

The study enrolled COPD patients from Taiwan NHIRD who received treatment with fluticasone/salmeterol or budesonide/formoterol for > 90 days between 2004 and 2011. The incidence of active TB was the primary outcome.

RESULTS

Among the intention-to-treat population prior to matching, the incidence rates of active TB were 0.94 and 0.61% in the fluticasone/salmeterol and budesonide/formoterol groups, respectively. After matching, the fluticasone/salmeterol group had significantly higher rates of active TB (adjusted HR, 1.41, 95% CI, 1.17-1.70) compared with the budesonide/formoterol group. The significant difference between these two groups remained after a competing risk analysis (HR, 1.45, 95% CI, 1.21-1.74). Following propensity score matching, the fluticasone/salmeterol group had significantly higher rates of active TB compared with the budesonide/formoterol group (adjusted HR, 1.45, 95% CI, 1.14-1.85). A similar trend was observed after a competing risk analysis (HR, 1.44, 95% CI, 1.19-1.75). A higher risk of active TB was observed in the fluticasone/salmeterol group compared with the budesonide/formoterol group across all subgroups, but some differences did not reach statistical significance.

CONCLUSION

Fluticasone/salmeterol carried a higher risk of active TB compared with budesonide/formoterol among COPD patients.

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.Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, 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, 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. dtmed141@gmail.com.Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. haochienwang@gmail.com.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
Observational Study

Language

eng

PubMed ID

32977747

Citation

Huang, Tsan-Ming, et al. "Risk of Active Tuberculosis Among COPD Patients Treated With Fixed Combinations of Long-acting Beta2 Agonists and Inhaled Corticosteroids." BMC Infectious Diseases, vol. 20, no. 1, 2020, p. 706.
Huang TM, Kuo KC, Wang YH, et al. Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids. BMC Infect Dis. 2020;20(1):706.
Huang, T. M., Kuo, K. C., Wang, Y. H., Wang, C. Y., Lai, C. C., Wang, H. C., Chen, L., & Yu, C. J. (2020). Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids. BMC Infectious Diseases, 20(1), 706. https://doi.org/10.1186/s12879-020-05440-6
Huang TM, et al. Risk of Active Tuberculosis Among COPD Patients Treated With Fixed Combinations of Long-acting Beta2 Agonists and Inhaled Corticosteroids. BMC Infect Dis. 2020 Sep 25;20(1):706. PubMed PMID: 32977747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids. AU - Huang,Tsan-Ming, AU - Kuo,Kuan-Chih, AU - Wang,Ya-Hui, AU - Wang,Cheng-Yi, AU - Lai,Chih-Cheng, AU - Wang,Hao-Chien, AU - Chen,Likwang, AU - Yu,Chong-Jen, AU - ,, Y1 - 2020/09/25/ PY - 2019/12/10/received PY - 2020/09/21/accepted PY - 2020/9/26/entrez PY - 2020/9/27/pubmed PY - 2020/10/21/medline KW - Budesonide/formoterol KW - COPD KW - Fluticasone/salmeterol KW - Tuberculosis SP - 706 EP - 706 JF - BMC infectious diseases JO - BMC Infect Dis VL - 20 IS - 1 N2 - OBJECTIVES: To investigate the incidence of active tuberculosis (TB) among COPD patients using fluticasone/salmeterol or budesonide/formoterol, and to identify any differences between these two groups of patients. METHODS: The study enrolled COPD patients from Taiwan NHIRD who received treatment with fluticasone/salmeterol or budesonide/formoterol for > 90 days between 2004 and 2011. The incidence of active TB was the primary outcome. RESULTS: Among the intention-to-treat population prior to matching, the incidence rates of active TB were 0.94 and 0.61% in the fluticasone/salmeterol and budesonide/formoterol groups, respectively. After matching, the fluticasone/salmeterol group had significantly higher rates of active TB (adjusted HR, 1.41, 95% CI, 1.17-1.70) compared with the budesonide/formoterol group. The significant difference between these two groups remained after a competing risk analysis (HR, 1.45, 95% CI, 1.21-1.74). Following propensity score matching, the fluticasone/salmeterol group had significantly higher rates of active TB compared with the budesonide/formoterol group (adjusted HR, 1.45, 95% CI, 1.14-1.85). A similar trend was observed after a competing risk analysis (HR, 1.44, 95% CI, 1.19-1.75). A higher risk of active TB was observed in the fluticasone/salmeterol group compared with the budesonide/formoterol group across all subgroups, but some differences did not reach statistical significance. CONCLUSION: Fluticasone/salmeterol carried a higher risk of active TB compared with budesonide/formoterol among COPD patients. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/32977747/Risk_of_active_tuberculosis_among_COPD_patients_treated_with_fixed_combinations_of_long_acting_beta2_agonists_and_inhaled_corticosteroids_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05440-6 DB - PRIME DP - Unbound Medicine ER -