Pneumonia among COPD patients using inhaled corticosteroids and long-acting bronchodilators

被引:24
|
作者
Mapel, Douglas [1 ]
Schum, Michael [1 ]
Yood, Marianne [2 ]
Brown, Jeffrey [3 ]
Miller, David [4 ]
Davis, Kourtney [4 ]
机构
[1] Lovelace Clin Fdn, Albuquerque, NM 87106 USA
[2] Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Hamden, CT USA
[3] Harvard Univ, Sch Med, Harvard Pilgrim Hlth Care, Boston, MA USA
[4] GlaxoSmithKline, Res Triangle Pk, NC USA
来源
PRIMARY CARE RESPIRATORY JOURNAL | 2010年 / 19卷 / 02期
关键词
COPD; pneumonia; corticosteroids; beta-agonists;
D O I
10.4104/pcrj.2009.00072
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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 /0CI: 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. 2010 Primary Care Respiratory Society UK. All rights reserved. D Mapel et al. Prim Care Resp J 2010; 19(2): 109-117 doi:10.4104/pcrj.2009.00072
引用
收藏
页码:109 / 117
页数:9
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