Do Inhaled Corticosteroids Elevate Pneumonia Risk in Patients With Asthma?

The use of inhaled corticosteroids is tied to a greater risk of pneumonia in patients with asthma, according to researchers. 

Previous studies have suggested that patients with chronic obstructive pulmonary disease (COPD) who use inhaled corticosteroids have a greater risk for pneumonia, but the amount of risk in patients with asthma has been uncertain.
______________________________________________________________________________________________________________________________________________
RELATED CONTENT
Healthy Diet Could Decrease COPD Risk
Bronchial Thermoplasty: Which Patients Will Respond?
______________________________________________________________________________________________________________________________________________

To better understand the potential risks, investigators examined data from Quebec health insurance databases and formed a cohort of 152,412 patients with asthma. The patients were treated from 1990-2007.

Of the 152,412 patients, there were 1,928 who had a pneumonia event during follow up. Researchers found that pneumonia risk was significantly increased among individuals currently using inhaled corticosteroids. Current use of inhaled corticosteroids was linked with an 83% increase in risk of hospitalization for pneumonia.

Risk of pneumonia hospitalization increased with higher doses of inhaled corticosteroids, researchers noted. For example, 500 μg or more of fluticasone-equivalent was associated with a 96% increase in risk.

Budesonide was linked with a 167% increase in risk, and fluticasone was associated with a 93% increase in risk.

“In conclusion, this study shows that the risk for pneumonia, in particular, serious pneumonia leading to hospitalization, in asthma patients is indeed elevated in relation to inhaled corticosteroid use. Both budesonide and fluticasone are associated with a statistically significant increase in risk for pneumonia,” the study’s authors wrote. However, lead author Pierre Ernst, MD, pointed out that in patients with asthma, pneumonia is still “unusual” and that “inhaled corticosteroids remain the best therapy available.”

—Lauren LeBano

Reference

Qian CJ, Coulombe J, Suissa S, Ernst P. Pneumonia risk in asthma patients using inhaled corticosteroids: a quasi-cohort study. Br J Pharmacol. 2017. doi:10.1111/bcp.13295.