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27-04-2010 | Respiratory | Article

ICS reduces mortality risk in COPD patients with pneumonia

Abstract

Free abstract

MedWire News: The use of inhaled corticosteroids (ICS) is associated with reduced mortality among chronic obstructive pulmonary disease (COPD) patients with pneumonia, research suggests.

“Recent studies suggest that use of ICS in COPD may be associated with a higher incidence of pneumonia,” explain M Restrepo (University of Texas Health Science Center, San Antonio, USA) and team.

“However, it is unclear if COPD subjects on ICS who develop pneumonia have worse outcomes,” they add.

To investigate, the team studied data on 6353 patients with COPD, aged an average of 74.7 years, who were hospitalized because of pneumonia between 1999 and 2000. Of these, 38% were taking ICS before hospital admission.

In total, 566 (8.9%) patients died within 30 days of admission and 1016 (16.0%) died within 90 days of admission. Among ICS users, 133 (6%) had died by day 30 and 282 (12%) by day 90, while among those who did not use ICS, 433 (11%) had died by day 30 and 734 (19%) by day 90.

After accounting for age, gender, ethnicity, comorbidities, and other variables, the researchers found that prior outpatient use of ICS was associated with a 24% reduced mortality risk at 30 days and a 20% reduced mortality risk at 90 days after admission compared with no prior use of ICS.

Restrepo and team conclude in the European Respiratory Journal: “This study showed that outpatient therapy with ICS was associated with a significant lower 30- and 90-day mortality in hospitalized COPD patients with pneumonia.

“These results render new perspectives for the safety of ICS and potential future application of ICS as an immunomodulatory therapy of pneumonia.”

They add: “Further study in prospective COPD cohorts is needed.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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