Corticosteroid Use Associated with Pneumonia in COPD

Using inhaled drugs for at least 24 weeks linked to higher pneumonia risk, but not risk of death
By Eric Metcalf
HealthDay Reporter

MONDAY, Feb. 9 (HealthDay News) -- Long-term inhaled corticosteroid use in patients with chronic obstructive pulmonary disease (COPD) is associated with an increased risk of pneumonia, though without a significantly higher risk of pneumonia-related death, according to a review article published in the Feb. 9 issue of the Archives of Internal Medicine.

Sonal Singh, M.D., of the Wake Forest University School of Medicine in Winston-Salem, N.C., and colleagues conducted a meta-analysis of 18 randomized controlled trials of more than 24 weeks' duration, including nearly 17,000 participants.

The use of inhaled corticosteroids was associated with a higher risk of pneumonia compared with controls (relative risk, 1.60), the researchers report. These medications were also associated with a higher risk of serious pneumonia according to 16 of the trials (RR, 1.71). However, their use was not associated with a significantly higher risk of pneumonia-related mortality or overall mortality, the report indicates.

"The magnitude of this risk of serious pneumonia associated with inhaled corticosteroid use in patients with COPD is substantial and may pose a substantial public health burden," the authors write. "Clinicians should remain vigilant for the development of pneumonia with inhaled corticosteroid use because the signs and symptoms of pneumonia may closely mimic those of COPD exacerbations. Clinicians should reevaluate the benefit-harm profile of long-term inhaled corticosteroid use among patients with COPD."

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