An analysis has indicated that patients with chronic obstructive pulmonary disease (COPD) who are hospitalised for pneumonia and treated with inhaled corticosteroids (ICS) have decreased mortality when compared to those who are not treated with ICS.
The use of ICS in COPD patients reduces exacerbations, but increases the rate of pneumonia.
Mortensen and colleagues examined the medical records of 15,768 COPD patients over the age of 65 who had been admitted to the VA hospitals. The study found that those who were not treated with ICS had about a 25% 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, investigator at VERDICT (Veterans Evidence-based Research, Dissemination, and Implementation Center, a VA Health Services Research and Development programme) and principal investigator on the study.
"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," added Mortensen.
The results have been published in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
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