Discontinuing ICS use in COPD reduces risk for pneumonia
Patients with COPD who discontinued using inhaled corticosteroids experienced a more than 25% decrease in the rate of serious pneumonia, according to study results.
“We showed a major risk reduction, particularly for fluticasone, using a large population-based cohort with long follow-up,” Samy Suissa, PhD, director of the Centre for Clinical Epidemiology at the Lady Davis Institute in Montreal, and colleagues wrote.
Suissa and colleagues created a user cohort of patients with COPD treated with inhaled corticosteroids (ICS) during 1990 to 2005 using the Quebec health insurance databases. The researchers followed 103,386 ICS users through 2007 or until a serious pneumonia event to analyze if the discontinuation of ICS reduced the elevated risk for pneumonia.
The researchers noted a 37% decrease (RR = 0.63; 95% CI, 0.6-0.66) in the rate of serious pneumonia in patients discontinuing ICS use.
The risk reduction increased from 20% during the first month after discontinuing use to 50% by the fourth month.
“Thus, we conclude that limiting the use of ICS to the patients with COPD who are likely to benefit, such as patients with an asthma component, and weaning the others off ICS will result in a major reduction in the risk of serious pneumonia,” the researchers wrote. – by Ryan McDonald
Disclosure: Suissa reports receiving research grants from Boehringer Ingelheim and participating in advisory board meetings or as a speaker for AstraZeneca, Boehringer Ingelheim, Merck, Novartis and Pfizer.