Inhaled Corticosteroids and the Risk of Pneumonia in people with Asthma: A case control study.
Chest. 2013 Aug 29;
Authors: McKeever T, Harrison TW, Hubbard R, Shaw D
Abstract
BACKGROUND In clinical trials the use of inhaled corticosteroids is associated with an increased risk of pneumonia in people with chronic obstructive pulmonary disease but whether the same is true for people with asthma is not known. METHODS Using primary care data from The Health Improvement Network we identified people with asthma and from this cohort we identified cases with pneumonia/ lower respiratory tract infection, and age and sex matched controls. Conditional logistic regression was used to determine the association between the dose and type of inhaled corticosteroid and risk of pneumonia or LRTI. RESULTS There was a dose response relationship between strength of dose of inhaled corticosteroid and risk of pneumonia or lower respiratory tract infection (p-trend <0∙001), such that after adjusting for confounders people receiving the highest strength of inhaled corticosteroid (≥1000mcg) had a 2.04 (95% CI 1∙59 to 2∙64) increased risk of pneumonia or lower respiratory infection when compared to people with asthma who did not have a prescription for inhaled corticosteroids within the previous 90 days. CONCLUSION People with asthma receiving inhaled corticosteroids are at an increased risk of pneumonia or lower respiratory infection with people receiving higher doses at greater risk. Pneumonia should be considered as a possible side effect of inhaled corticosteroids and the lowest dose of inhaled corticosteroids possible should be used in the management of asthma.
PMID: 23990003 [PubMed - as supplied by publisher]