Patients with chronic obstructive pulmonary disease (COPD) who are hospitalized for pneumonia and treated with inhaled corticosteroids (ICS) have decreased mortality compared to those who are not treated with ICS, according to a recent study published in The American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.
The study examined the medical records of nearly 16,000 COPD patients over the age of 55 who had been admitted to Department of Veteran Affairs (VA) hospitals for pneumonia between 2002 and 2007. Roughly half of these patients had been treated with ICS (52.5 percent) and half had not (47.5 percent).
When researchers analyzed the causes of mortality between the two groups for both 30- and 90-day intervals, there were significant differences. For 30-day mortality, 10.2 percent of ICS users died, compared to 13.6 percent of those who were not treated with ICS. For 90-day mortality, 17.3 percent of ICS users died, compared to 22.8 percent who were not treated with ICS. Overall, those who were not treated with ICS had about a 25 percent greater mortality risk than those who were treated with ICS.
“These results have clear implications for current clinical practice, which has been informed in the past by a series of studies that found an increased risk of pneumonia with ICS use,” said Eric Mortensen, MD, investigator at Veterans Evidence-based Research, Dissemination, and Implementation Center (VERDICT), a VA Health Services Research and Development program, and principal investigator on the study, in a press release issued by the American Thoracic Society.
He continued, “In contrast, our study would suggest that ICS use may confer a survival benefit to these patients and may be employed when there are not contraindications. These results should reassure clinicians that they can give their COPD patients ICS without fearing that the increased risk of pneumonia will translate into higher risk of mortality.”