Patients with chronic obstructive pulmonary disease (COPD) are more likely to be hospitalized for pneumonia if they use inhaled corticosteroids than are COPD patients whose doctors do not prescribe the medication. That’s the conclusion of a study published in this month’s issue of the American Journal of Respiratory and Critical Care Medicine.
While earlier, less rigorous research seemed to indicate a correlation between inhaled anti-inflammatory drugs and pneumonia in COPD patients, many researchers and clinicians were skeptical.
McGill University epidemiologist Pierre Ernst, M.D., and his colleagues analyzed 15 years’ of hospitalization and prescription-drug information belonging to 175,906 COPD patients living in Quebec, Canada. During that time, 23,942 of the patients were hospitalized for pneumonia.
“We found that current inhaled corticosteroid use was associated with a significant 70 percent increase in the risk of being hospitalized for pneumonia,” the researchers write. “Furthermore, for the severest pneumonias leading to death within 30 days of hospitalization, the risk with current inhaled corticosteroid use was also significantly increased.”
Researchers found that hospital-admission rates for pneumonia correlated with inhaled-steroid dosage levels — the larger the dose, the greater the risk. Among all patients taking inhaled steroids, there was a 53 percent increase in pneumonia deaths within 30 days of being admitted to the hospital.
Pending more research, physicians must now re-assess their use of inhaled anti-inflammatories with their COPD patients. Before this month’s research appeared, other studies already questioned the effectiveness of corticosteroids for treating COPD.
In an editorial published in the same journal as the new research, Dr. Mark Woodhead, D.M., of the Manchester (U.K.) Royal Infirmary, writes, “The finding of an association between pneumonia frequency and inhaled corticosteroid use . . . means that the findings may be real and that these observations cannot simply be dismissed.”
