Montreal—Inhaled corticosteroids are a mainstay for asthma patients, but that doesn’t mean use of them is without significant risks, new research points out.
A report in the British Journal of Clinical Pharmacology notes that current use of inhaled corticosteroids (ICS) was associated with an 83% increased risk of being hospitalized for pneumonia. To determine that, McGill University–led researchers looked at 152,412 asthma patients; 1,928 had a pneumonia event during follow-up.
Study authors point out that the risk increases with dosage, noting that dispensing of 500 ?g or more of fluticasone-equivalent per day was associated with a 96% increase. In terms of specific formulations, use of budesonide was linked to a 167% increase in risk and fluticasone with a 93% increase in risk.
“While the increase in risk of pneumonia with the use of inhaled corticosteroids is well recognized in chronic obstructive pulmonary disease (COPD), in asthma patients the evidence has been equivocal,” explained senior author Pierre Ernst, MD. “Our study suggests the risk may be present in asthma, although pneumonia in patients with asthma remains unusual and inhaled corticosteroids remain the best therapy available.”
Researchers state that they set out to do the study because past research has linked the use of ICS to excess pneumonia risk in COPD patients, but the risk in asthma patients remained unclear.
Their study involved a cohort of asthma patients, aged 12 to 35 years, treated from 1990 to 2007 using Quebec health-insurance databases. The excess risk was determined to be 2.03 cases per 1,000 person-years and persisted even with low doses, rate ratio of 1.60; moderate doses, RR of 1.53; and high doses, RR of 1.96.
“ICS use in asthma patients appears associated with an increased risk of pneumonia and is present for both budesonide and fluticasone,” study authors conclude.
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