Newly published research out of Wake Forest University School of Medicine finds that a popular class of anti-inflammatory inhalers significantly increases the risk of pneumonia in patients with Chronic Obstructive Pulmonary Disease (COPD).
The study appears in this month's issue of Archives of Internal Medicine and focuses on the incidence of pneumonia in patients with COPD who were exposed to inhaled corticosteroid drugs, either alone or in combination with other drugs.
COPD is a progressive disease that makes it hard to breathe. It can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness and other symptoms. Cigarette smoking is the leading cause of COPD, and most people who have COPD smoke or are former smokers. Long-term exposure to other lung irritants, such as air pollution, chemical fumes or dust, also may contribute to COPD.
COPD is currently the fourth-leading cause of death in the United States, accounting for more than 120,000 deaths annually and costing more than $30 billion each year, according to the National Lung Health Education Program. It is estimated that more than 16 million Americans have COPD; however, that number is rising rapidly and the disease often goes undiagnosed, so some estimates put the actual number of Americans afflicted with the disease as high as 24 million.
Inhaled corticosteroids, used alone or in combination with other drugs for the treatment of asthma, are not approved for use alone in patients with COPD, but rather in combination with beta-antagonists, which dilate the lungs. The available inhaled steroid combinations are fluticasone/salmeterol, marketed byGlaxoSmithKline as AdvairTM, and budesonide/formoterol, marketed by AstraZeneca as SymbicortTM.
The inhalers are effective in relieving many of the symptoms of COPD, but have been associated with an increased risk of pneumonia in recent studies.
For the current study, researchers reviewed 18 randomized clinical trials, several of which were unpublished, involving nearly 17,000 patients in total. They compared the incidence of pneumonia in patients who had taken inhaled corticosteroids for at least 24 weeks versus patients who had taken a placebo, or patients who had taken combination inhaled corticosteroids and long-acting beta-antagonists versus patients who took only the long-acting bronchodilator.