Journal
EXPERT OPINION ON DRUG SAFETY
Volume 14, Issue 8, Pages 1237-1247Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14740338.2015.1057494
Keywords
chronic obstructive pulmonary disease; inhaled corticosteroids; long-acting beta-agonists; mortality; pneumonia
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Introduction: Inhaled corticosteroids (ICS) are known to increase the risk of pneumonia in patients with chronic obstructive pulmonary disease. To estimate the association between ICS and pneumonia among users of ICS relative to non-ICS users and to examine whether this risk is dose related, class related and what's its association with the pneumonia-mortality or overall mortality. Areas covered: Through a comprehensive literature search of MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials.gov from inception to February 2015, we identified randomized controlled trials of ICS therapy lasting at least 6 months. We conducted meta-analyses to generate summary estimates comparing ICS with non-ICS treatment on the risk of pneumonia. Expert opinion: ICS alone or in combination with long-acting beta-agonists are associated with an increased risk of pneumonia but have no effect on pneumonia related mortality. It is important to identify those patients to benefit the most from ICS, as those with frequent exacerbations, a severe airway obstruction, a positive bronchodilator test or a sputum eosinophilia despite treatment.
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