Table 3.
Relevant case–control studies that reported on the risk of pneumonia in patients treated with ICS for COPD.
| Study | n | Country | Period | ICS | Pneumonia OR/HR (95% CI)¶ | Mortality OR/HR (95% CI)Þ | Dose–effect relationship | Industry funding |
|---|---|---|---|---|---|---|---|---|
| Increased risk of pneumonia with ICS | ||||||||
| Ernst et al. [2007] | 175,906 | Canada | Jan 1988 Dec 2001 |
No distinction | 1.70 (1.63–1.77) | 1.53 (1.30–1.80) | Yes | No |
| Joo et al. [2009] | 145,586 | US | Oct 1999 Sep 2002 |
No distinction | 1.38 (1.31–1.45) | 0.77 (0.75–0.80) | No | No |
| Thornton Snider et al. [2012] | 83,455 | US | Jan 2009 Sep 2011 |
No distinction | 1.26 (1.16–1.36) | NR | Yes | Novartis |
| Yawn et al. [2013] | 135,445 | US | Jan 2006 Sep 2010 |
No distinction | 1.51 (1.42–1.61) | NR | Yes | Novartis |
|
Janson
et al. [2013]
(PATHOS) |
5468 | Sweden | Jan 1999 Dec 2009 |
FP versus BUD | 1.74 (1.56–1.94) | 1.76 (1.22–2.53) | No | AstraZeneca ƒ |
| Suissa [2013] | 163,514 | Canada | Jan 1990 Dec 2005 |
FP BUD Total |
2.01 (1.93–2.10) 1.17 (1.09–1.26) 1.69 (1.63–1.75) |
NR | Yes | No |
| DiSantostefano et al. [2014] | 18,047 | UK | Jan 2002 Dec 2010 |
No distinction | 1.49 (1.22–1.83) | NR | Yes | GlaxoSmithKline Ŧ |
| Kern et al. [2015] | 7394 | US | NR | BUD versus FP | 0.92 (0.81–1.04) | NR | NR | AstraZeneca ƒ |
| No increased risk of pneumonia with ICS | ||||||||
| Mapel et al. [2010] | 5245 | US | Sep 2001 Aug 2003 |
ICS alone ICS/LABA |
1.29 (0.96–1.73) 1.03 (0.74–1.42) |
NR | NA | GlaxoSmithKline |
| Festic et al. [2014] | 589¥ | US | Mar 2009 Aug 2009 |
No distinction | 1.40 (0.95–2.09) | NR | NA | No |
| Gershon et al. [2014] | 11,872 | Canada | Sep 2003 Mar 2011 |
ICS/LABA versus
LABA alone |
1.01 (0.93–1.08) | 0.92 (0.87–0.97) | NA | No |
RCT, randomized controlled trial; ICS, inhaled corticosteroids; COPD, chronic obstructive pulmonary disease; LABA, long acting β2-agonist; FP, fluticasone propionate; BUD, budesonide; OR, odds ratio; HR, hazard ratio; CI, confidence interval; NR, not reported; NA, not applicable.
Hospitalization for, or death from, pneumonia, unless otherwise specified.
Pneumonia-related mortality unless otherwise specified.
This study was funded by AstraZeneca, which also took part in the data collection and analysis, the interpretation of the data, and the drafting of the manuscript.
This study was funded by GlaxoSmithKline, but did not have any additional role in the study design, data collection and analysis or preparation of the manuscript.
Subset of patients with COPD.