Evidence map›Paper›PMID 19926996›Full record

SynthesisCurrent opinion in pulmonary medicine2010

Risk of pneumonia associated with long-term use of inhaled corticosteroids in chronic obstructive pulmonary disease: a critical review and update.

Sonal Singh, Yoon K Loke

Abstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Current opinion in pulmonary medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Accelerated progression of pulmonary tuberculosis in a COVID-19 patient after corticosteroid treatment.Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi · 2022
    Article
  6. Article
  7. Review
  8. GOLD 2021 Strategy Report: Implications for Asthma-COPD Overlap.International journal of chronic obstructive pulmonary disease · 2021
    Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Future Research Directions in Pneumonia. NHLBI Working Group Report.American journal of respiratory and critical care medicine · 2018
    Article
  15. Role of eosinophils in airway inflammation of chronic obstructive pulmonary disease.International journal of chronic obstructive pulmonary disease · 2018
    Review
  16. Review
  17. Review
  18. Article
  19. Review
  20. Maintenance therapy in COPD: time to phase out ICS and switch to the new LAMA/LABA inhalers?International journal of chronic obstructive pulmonary disease · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Sonal SinghDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. ssingh31@jhu.edu
Yoon K Loke

Funding

Institute for Clinical and Translational Research (KL2)KL2RR025006 · NCRR · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2007 to 2011
$12.9M
NCRR NIH HHS 1KL2RR025006-03NCRR NIH HHS KL2 RR025006
6 · The paper itself

Abstract

purpose of reviewThe aim was to determine the effects of long-term inhaled corticosteroid use on pneumonia in patients with chronic obstructive pulmonary disease (COPD) via systematic searches of MEDLINE, EMBASE, ISI, regulatory documents and manufacturers' trial registries. RECENT

findingsOur updated meta-analysis of 24 long-term randomized controlled trials involving 23 096 participants shows a significantly increased risk of pneumonia with the use of inhaled corticosteroids in COPD (relative risk 1.57, 95% confidence interval 1.41-1.75, P < 0.0001). The increased risk of pneumonia is not accompanied by a corresponding increase in mortality. The elderly and those with more severe disease and lower forced expiratory volume in 1s are at the highest risk of pneumonia. The trials of currently available inhaled corticosteroids have included participants with varying duration of inhaled corticosteroid exposure and COPD severity, with apparent differences in the proportion of pneumonia ascertained among these trials. The absence of adequately powered long-term head-to-head trials precludes any definitive conclusions on intraclass differences in risk. SUMMARY: Clinicians should consider the long-term risks of pneumonia with the use of inhaled corticosteroids in patients with COPD. Adequately powered long-term head-to-head trials with objective pneumonia definitions, active ascertainment and radiologic and microbiologic confirmation are needed to clarify any intraclass differences in the risk of pneumonia.

Indexed as

Administration, InhalationAdrenal Cortex HormonesDose-Response Relationship, DrugHumansPneumoniaPulmonary Disease, Chronic ObstructiveRisk FactorsTime FactorsAdrenal Cortex Hormones

Identifiers

PMID19926996
PMCPMC2908947

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.