Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease

Sonal Singh, Aman V. Amin, Yoon K. Loke

Research output: Contribution to journalArticle

Abstract

Background: Recent studies have suggested a possible association between pneumonia and the use of inhaled corticosteroids. We aimed to ascertain the risk of pneumonia with long-term inhaled corticosteroid use among patients with chronic obstructive pulmonary disease (COPD). Methods: We performed systematic searches with no date restrictions through June 30, 2008, of MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, regulatory documents, and trial registries. We included randomized controlled trials of any inhaled cor-ticosteroid vs a control treatment for COPD, with at least 24 weeks of follow-up and reporting of pneumonia as an adverse event. Outcomes evaluated included any pneumonia, serious pneumonia, pneumonia-related mortality, and overall mortality. Results: Eighteen randomized controlled trials (n=16 996) with 24 to 156 weeks of follow-up were included after a detailed screening of 97 articles. Inhaled corticosteroids were associated with a significantly increased risk of any pneumonia (relative risk [RR], 1.60; 95% confidence interval [CI], 1.33-1.92 [P2= 16%) and serious pneumonia (1.71; 1.46-1.99 [P 2=0%) but without a significantly increased risk of pneumonia-related mortality (1.27; 0.80-2.03 [P =. 31]; I 2 or overall mortality (0.96; 0.86-1.08 [P=.51]; I 2=0%). Inhaled corticosteroids were associated with a significantly increased risk of serious pneumonia when compared with placebo (RR, 1.81; 95% CI, 1.44-2.29 [P

Original languageEnglish (US)
Pages (from-to)219-229
Number of pages11
JournalArchives of Internal Medicine
Volume169
Issue number3
DOIs
StatePublished - Feb 9 2009
Externally publishedYes

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Chronic Obstructive Pulmonary Disease
Pneumonia
Adrenal Cortex Hormones
Mortality
Randomized Controlled Trials
Confidence Intervals
MEDLINE
Registries
Placebos
Databases

ASJC Scopus subject areas

  • Internal Medicine

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Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease. / Singh, Sonal; Amin, Aman V.; Loke, Yoon K.

In: Archives of Internal Medicine, Vol. 169, No. 3, 09.02.2009, p. 219-229.

Research output: Contribution to journalArticle

Singh, Sonal ; Amin, Aman V. ; Loke, Yoon K. / Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease. In: Archives of Internal Medicine. 2009 ; Vol. 169, No. 3. pp. 219-229.
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