RT Journal Article
SR Electronic
T1 Pneumonia in COPD patients treated with fixed ICS/LABA combinations
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2897
VO 40
IS Suppl 56
A1 Christer Janson
A1 Kjell Larsson
A1 Karin Lisspers
A1 Björn Ställberg
A1 Georgios Stratelis
A1 Gunilla Telg
A1 Leif Jörgensen
A1 Gunnar Johansson
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2897.abstract
AB BackgroundInhaled corticosteroids (ICS) in combination with long-acting β2-agonists (LABA) improve quality of life and reduce exacerbations in chronic obstructive pulmonary disease (COPD). Increased prevalence of pneumonia has been indicated during treatment with fluticasone but not with budesonide, but no direct comparisons have been performed.ObjectivesTo investigate occurrence of pneumonia in a COPD population treated with fixed ICS/LABA combination; budesonide/formoterol (B/F) or fluticasone/salmeterol (F/S) (NCT01146392).MethodsMedical records' data from primary care patients ≥ 18 years was linked to Swedish hospital and drug register data for 1999 – 2009. Index date was first prescription of a fixed ICS/LABA combination post COPD diagnosis. Propensity score matching was done at index date.ResultsThe total sample covered 9,893 patients. Matching gave two equivalent populations (2,734 patients/group) using either B/F or F/S at index. Mean prescribed daily steroid dose was 562 µg budesonide and 786 µg fluticasone.In all, 15,353 pneumonia diagnoses were seen. 44% of all patients had experienced pneumonia within 8 years post COPD diagnosis. Yearly rate of pneumonia for B/F was significantly lower, 0.062 compared to 0.11 for F/S; 44% difference (p<0.0001). Yearly rate of hospitalisations due to pneumonia was 0.041 vs 0.074 (-45%); days at hospital/year 0.34 vs 0.63 (-46%) for B/F vs F/S, respectively. Time to first diagnosis of pneumonia showed a hazard ratio of 0.794 (95% CI 0.706, 0.892) in favor of B/F.ConclusionIn this observational register study, COPD patients treated with budesonide/formoterol experienced fewer pneumonias than patients treated with fluticasone/salmeterol.Study sponsor; AstraZeneca.