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ATS: Risk of Pneumonia Up With Inhaled Corticosteroids in COPD

Observational studies show reduction in odds of pneumonia-associated, all-cause mortality

WEDNESDAY, May 20, 2015 (HealthDay News) -- Treatment of chronic obstructive pulmonary disease (COPD) with inhaled corticosteroids (ICS) is associated with increased risk of pneumonia, but may reduce the risk of pneumonia-associated and all-cause mortality, according to research findings presented at the annual meeting of the American Thoracic Society, held from May 15 to 20 in Denver.

Ena Gupta, M.D., M.P.H., from the University of Florida College of Medicine in Jacksonville, and colleagues performed a systematic review and meta-analysis of studies involving COPD patients using ICS and a comparison arm lacking ICS. Data were included from 38 studies: 29 randomized controlled trials and nine observational trials.

The researchers found that the estimated unadjusted risk of pneumonia was increased in randomized trials and observational studies (relative risk, 1.61 [95 percent confidence interval (CI), 1.35 to 1.93] and odds ratio [OR], 1.89 [95 percent CI, 1.39 to 2.59], respectively). No difference was seen in pneumonia-associated mortality in six estimable randomized trials, while in seven estimable observational studies there was a decrease in pneumonia-associated mortality (OR, 0.72; 95 percent CI, 0.59 to 0.88). No difference was seen in the unadjusted risk of overall mortality, based on 29 randomized trials, while six observational studies showed a decrease in overall mortality in the ICS group (OR, 0.79; 95 percent CI, 0.65 to 0.97).

"This benefit may be due to the immunosuppressive and anti-inflammatory effects of ICS treatment," Gupta said in a statement.

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