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Higher Pneumonia Risk with Inhaled Corticosteroids

Meta-analysis shows risk of pneumonia, but not mortality, significantly increased with use of inhaled corticosteroid therapy

TUESDAY, Nov. 25 (HealthDay News) -- Inhaled corticosteroid use is associated with an increased risk of pneumonia, but not mortality, in patients with chronic obstructive pulmonary disease (COPD), according to the results of a meta-analysis published Nov. 26 in the Journal of the American Medical Association.

M. Bradley Drummond, M.D., of Johns Hopkins University in Baltimore, and colleagues evaluated 11 randomized controlled trials that compared inhaled corticosteroid therapy with non-steroid inhaled therapy for at least six months in patients with COPD.

The investigators found no significant difference in one-year all-cause mortality rate between the two drug treatment groups. However, inhaled corticosteroid use was significantly associated with a 1.34-fold increased risk of pneumonia, compared with non-steroid inhaled therapy use. A subgroup analysis showed that individuals at the highest risk of developing pneumonia were patients receiving the highest inhaled corticosteroid dose, patients having the shortest duration of inhaled corticosteroid therapy, patients with the lowest baseline levels of forced expiratory volume in the first second of expiration, and patients receiving a combined therapy consisting of inhaled corticosteroids and a bronchodilator.

"Our study reinforces the importance for clinicians to weigh the potential risks and benefits of inhaled corticosteroid therapy in patients with stable COPD," the authors write.

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