Document Detail


Pneumonia among COPD patients using inhaled corticosteroids and long-acting bronchodilators.
MedLine Citation:
PMID:  20082059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Douglas Mapel; Michael Schum; Marianne Yood; Jeffrey Brown; David Miller; Kourtney Davis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Primary care respiratory journal : journal of the General Practice Airways Group     Volume:  19     ISSN:  1475-1534     ISO Abbreviation:  Prim Care Respir J     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-01     Completed Date:  2010-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121543     Medline TA:  Prim Care Respir J     Country:  England    
Other Details:
Languages:  eng     Pagination:  109-17     Citation Subset:  IM    
Affiliation:
Lovelace Clinic Foundation, Albuquerque, New Mexico 87106, USA. dmapel@comcast.net
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adrenal Cortex Hormones / administration & dosage,  adverse effects,  therapeutic use*
Adult
Age Factors
Aged
Albuterol / administration & dosage,  adverse effects,  analogs & derivatives,  therapeutic use
Androstadienes / administration & dosage,  adverse effects,  therapeutic use
Bronchodilator Agents / administration & dosage,  adverse effects,  therapeutic use*
Case-Control Studies
Delayed-Action Preparations / adverse effects
Drug Therapy, Combination / adverse effects
Female
Humans
Longitudinal Studies
Male
Middle Aged
Odds Ratio
Pneumonia / etiology*
Pulmonary Disease, Chronic Obstructive / complications,  drug therapy*
Risk Factors
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Androstadienes; 0/Bronchodilator Agents; 0/Delayed-Action Preparations; 18559-94-9/Albuterol; 89365-50-4/salmeterol; 90566-53-3/fluticasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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