Back to Search
Start Over
Comparative Safety and Effectiveness of Inhaled Corticosteroid and Long-Acting β2-Agonist Combinations in Patients With COPD.
- Source :
-
CHEST . May2020, Vol. 157 Issue 5, p1117-1129. 13p. - Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>The differential risk of pneumonia among inhaled corticosteroid (ICS) use in patients with COPD requires more investigation, especially regarding beclomethasone-containing inhalers. The goal of this study was to compare the risk and benefit profile of different ICS/long-acting β2-agonist (LABA) combinations in patients with COPD.<bold>Methods: </bold>This retrospective cohort study was conducted by using national health insurance claims data from the years 2009 to 2015 in Taiwan and included patients with COPD with new ICS/LABA use. Propensity score matching and Cox regression models were used to estimate the hazard ratios of severe pneumonia and acute exacerbation for different ICS/LABA users.<bold>Results: </bold>Both budesonide/formoterol (BUD/FOR) dry-powder inhalers and beclomethasone/formoterol (BEC/FOR) metered-dose inhalers, compared with fluticasone propionate/salmeterol (FLU/SAL) delivered via the same device type, were associated with a lower risk of severe pneumonia (BUD/FOR hazard ratio [HR], 0.83 [95% CI, 0.70-0.98]; BEC/FOR HR, 0.69 [95% CI, 0.58-0.81]) and severe acute exacerbation (BUD/FOR HR, 0.88 [95% CI, 0.78-0.99]; BEC/FOR HR, 0.82 [95% CI, 0.72-0.93]). After additionally adjusting for the average daily ICS dose, BUD/FOR dry-powder inhaler users continued to have a significantly decreased risk of severe pneumonia (18%), although BEC/FOR metered-dose inhaler users did not. The results were consistent in most of the prespecified subgroups and across all the sensitivity analyses.<bold>Conclusions: </bold>This study augments the existing evidence concerning the different safety and effectiveness outcomes of ICS/LABA combinations in patients with COPD, which may be considered when making clinical treatment decisions. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PNEUMONIA
*GLUCOCORTICOIDS
*ADRENERGIC beta agonists
*RESEARCH
*ADRENOCORTICAL hormones
*COMBINATION drug therapy
*RESPIRATORY therapy equipment
*RESEARCH methodology
*RETROSPECTIVE studies
*MEDICAL cooperation
*EVALUATION research
*BRONCHODILATOR agents
*COMPARATIVE studies
*OBSTRUCTIVE lung diseases
*INHALATION administration
*BUDESONIDE
*PROBABILITY theory
*BECLOMETHASONE dipropionate
Subjects
Details
- Language :
- English
- ISSN :
- 00123692
- Volume :
- 157
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- CHEST
- Publication Type :
- Academic Journal
- Accession number :
- 142869029
- Full Text :
- https://doi.org/10.1016/j.chest.2019.12.006