Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study

Jae-Hwa Choi,1,&ast; Keun-Bae Jeong,1,&ast; You Hyun Park,2 Iseul Yu,1 Seok Jeong Lee,1 Myoung Kyu Lee,1 Sang-Ha Kim,1 Won-Yeon Lee,1 Suk Joong Yong,1 Ji-Ho Lee1 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea; 2Department of Biostatistics, Yonsei...

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Autores principales:	Choi JH, Jeong KB, Park YH, Yu I, Lee SJ, Lee MK, Kim SH, Lee WY, Yong SJ, Lee JH
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	inhaled corticosteroid chronic obstructive pulmonary disease pneumonia fluticasone propionate budesonide Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/7e07e19e189f4aee9037525586af9cce
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spelling	oai:doaj.org-article:7e07e19e189f4aee9037525586af9cce2021-11-25T18:55:29ZComparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study1178-2005https://doaj.org/article/7e07e19e189f4aee9037525586af9cce2021-11-01T00:00:00Zhttps://www.dovepress.com/comparison-of-risk-of-pneumonia-caused-by-fluticasone-propionate-versu-peer-reviewed-fulltext-article-COPDhttps://doaj.org/toc/1178-2005Jae-Hwa Choi,1,&ast; Keun-Bae Jeong,1,&ast; You Hyun Park,2 Iseul Yu,1 Seok Jeong Lee,1 Myoung Kyu Lee,1 Sang-Ha Kim,1 Won-Yeon Lee,1 Suk Joong Yong,1 Ji-Ho Lee1 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea; 2Department of Biostatistics, Yonsei University, Seoul, Korea&ast;These authors contributed equally to this workCorrespondence: Ji-Ho LeeDepartment of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, 26426, KoreaTel +82-33-741-0926Fax +82-33-741-0928Email airwayleejh@yonsei.ac.krIntroduction: Inhaled corticosteroids (ICSs) play an important role in lowering the risk of acute exacerbation of chronic obstructive pulmonary disease (COPD). However, ICSs are known to increase the risk of pneumonia. Moreover, previous studies have shown that the incidence rate of pneumonia varies depending on the type of ICS. In this study, the risk of pneumonia according to the type of ICS was investigated in a population-based cohort.Methods: A retrospective cohort study was conducted using claims data of the entire population from the Korean National Health Insurance Service. Patients who were newly diagnosed with COPD and prescribed fluticasone propionate or budesonide were enrolled as study subjects. Cumulative doses of ICSs were classified into categorical variables to analyze the risk of pneumonia within identical ICS doses.Results: A total of 47,473 subjects were identified and allocated as 14,518 fluticasone propionate and 14,518 budesonide users through 1:1 propensity score matching. Fluticasone propionate users were more likely to develop pneumonia than budesonide users (14.22% vs 10.66%, p< 0.0001). The incidence rate per 100,000 person-years was 2,914.77 for fluticasone propionate users and 2,102.90 for budesonide users. The hazard ratio (HR) of pneumonia in fluticasone propionate compared to budesonide was 1.34 (95% CI 1.26– 1.43, p< 0.0001). The risk of pneumonia for fluticasone propionate compared to budesonide increased with higher ICS cumulative doses: 1.06 (0.93– 1.21), 1.41 (1.19– 1.66), 1.41 (1.23– 1.63), and 1.49 (1.33– 1.66) from the lowest to highest quartiles, respectively.Conclusion: ICS types and doses need to be carefully considered during treatment with ICSs in patients with COPD.Keywords: inhaled corticosteroid, chronic obstructive pulmonary disease, pneumonia, fluticasone propionate, budesonideChoi JHJeong KBPark YHYu ILee SJLee MKKim SHLee WYYong SJLee JHDove Medical Pressarticleinhaled corticosteroidchronic obstructive pulmonary diseasepneumoniafluticasone propionatebudesonideDiseases of the respiratory systemRC705-779ENInternational Journal of COPD, Vol Volume 16, Pp 3229-3237 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	inhaled corticosteroid chronic obstructive pulmonary disease pneumonia fluticasone propionate budesonide Diseases of the respiratory system RC705-779
spellingShingle	inhaled corticosteroid chronic obstructive pulmonary disease pneumonia fluticasone propionate budesonide Diseases of the respiratory system RC705-779 Choi JH Jeong KB Park YH Yu I Lee SJ Lee MK Kim SH Lee WY Yong SJ Lee JH Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study
description	Jae-Hwa Choi,1,&ast; Keun-Bae Jeong,1,&ast; You Hyun Park,2 Iseul Yu,1 Seok Jeong Lee,1 Myoung Kyu Lee,1 Sang-Ha Kim,1 Won-Yeon Lee,1 Suk Joong Yong,1 Ji-Ho Lee1 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea; 2Department of Biostatistics, Yonsei University, Seoul, Korea&ast;These authors contributed equally to this workCorrespondence: Ji-Ho LeeDepartment of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, 26426, KoreaTel +82-33-741-0926Fax +82-33-741-0928Email airwayleejh@yonsei.ac.krIntroduction: Inhaled corticosteroids (ICSs) play an important role in lowering the risk of acute exacerbation of chronic obstructive pulmonary disease (COPD). However, ICSs are known to increase the risk of pneumonia. Moreover, previous studies have shown that the incidence rate of pneumonia varies depending on the type of ICS. In this study, the risk of pneumonia according to the type of ICS was investigated in a population-based cohort.Methods: A retrospective cohort study was conducted using claims data of the entire population from the Korean National Health Insurance Service. Patients who were newly diagnosed with COPD and prescribed fluticasone propionate or budesonide were enrolled as study subjects. Cumulative doses of ICSs were classified into categorical variables to analyze the risk of pneumonia within identical ICS doses.Results: A total of 47,473 subjects were identified and allocated as 14,518 fluticasone propionate and 14,518 budesonide users through 1:1 propensity score matching. Fluticasone propionate users were more likely to develop pneumonia than budesonide users (14.22% vs 10.66%, p< 0.0001). The incidence rate per 100,000 person-years was 2,914.77 for fluticasone propionate users and 2,102.90 for budesonide users. The hazard ratio (HR) of pneumonia in fluticasone propionate compared to budesonide was 1.34 (95% CI 1.26– 1.43, p< 0.0001). The risk of pneumonia for fluticasone propionate compared to budesonide increased with higher ICS cumulative doses: 1.06 (0.93– 1.21), 1.41 (1.19– 1.66), 1.41 (1.23– 1.63), and 1.49 (1.33– 1.66) from the lowest to highest quartiles, respectively.Conclusion: ICS types and doses need to be carefully considered during treatment with ICSs in patients with COPD.Keywords: inhaled corticosteroid, chronic obstructive pulmonary disease, pneumonia, fluticasone propionate, budesonide
format	article
author	Choi JH Jeong KB Park YH Yu I Lee SJ Lee MK Kim SH Lee WY Yong SJ Lee JH
author_facet	Choi JH Jeong KB Park YH Yu I Lee SJ Lee MK Kim SH Lee WY Yong SJ Lee JH
author_sort	Choi JH
title	Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study
title_short	Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study
title_full	Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study
title_fullStr	Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study
title_full_unstemmed	Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study
title_sort	comparison of risk of pneumonia caused by fluticasone propionate versus budesonide in chronic obstructive pulmonary disease: a nationwide retrospective cohort study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/7e07e19e189f4aee9037525586af9cce
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Comparison of Risk of Pneumonia Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study

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