TY - JOUR T1 - ICS and risk of pneumonia in Swedish COPD patients: The ARCTIC study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA3946 VL - 48 IS - suppl 60 SP - PA3946 AU - Christer Janson AU - Gunnar Johansson AU - Björn Ställberg AU - Karin Lisspers AU - Petter Olsson AU - Dorothy Keininger AU - Leif Jorgensen AU - Patrik Sobocki AU - Kjell Larsson Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA3946.abstract N2 - Background: Inhaled corticosteroid (ICS) use has been associated with pneumonia risk in the context of chronic obstructive pulmonary disease (COPD).Objective: To assess the risk of pneumonia among Swedish COPD patients treated with ICS.Methods: Retrospective electronic medical records (EMRs) data were collected from COPD patients and a matched reference group from Swedish primary care centers (2000-2014) and linked to information from national primary and secondary care registries. The COPD and matched reference group (non-COPD) patients were divided into three groups: high- (>800 µg daily budesonide), low- (<800 µg daily budesonide) and no-ICS use. Pneumonia was identified using the World Health Organization disease classification codes J12-J20, obtained from the EMRs. All COPD patients had mild or moderate COPD (FEV1 >50% predicted).Results: There were 593, 1,453 and 2,124 COPD patients and 3,464, 10,619 and 68,957 non-COPD patients in the high-, low- and no-ICS dose groups, respectively. Mean follow-up was 5.7 years (SD=4.1). ICS use at both low and high doses was associated with higher prevalence of pneumonia in COPD (low, HR 1.15 [95% CI 1.00, 1.32]; high, HR 1.23 [95% CI 1.04, 1.46]) compared to COPD patients not using ICS. An association between ICS use and pneumonia was also found in non-COPD patients (low, HR 1.66 [95% CI 1.56, 1.76]; high, HR 1.76 [95% CI 1.61, 1.93]) compared with no-ICS use in non-COPD patients. COPD patients had a higher risk of pneumonia than non-COPD patients (HR 3.33 [95% CI 3.12, 3.56]).Non-COPDCOPDNo ICS0.519Low-dose ICS722High-dose ICS1022% with pneumoniaConclusion: Having COPD or taking high- or low-dose ICS are both associated with increased risk of pneumonia. ER -