Evidence map›Paper›PMID 24130228›Full record

ArticleThorax2013

Inhaled corticosteroids in COPD and the risk of serious pneumonia.

Samy Suissa, Valérie Patenaude, Francesco Lapi, Pierre Ernst

Registry-linked trialOpen access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Thorax, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03046134 (Burden of Hospitalized Pneumonia and Its Clinical Characteristics in Korea COPD Population), which is not on this map. Cited by 185 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
185citing papers in PubMed, 8 pooled it
36.0field-weighted citation impact, top 1% of its field
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.

NCT03046134 unknown statusnot on this mapstarted 2017, after this paper: background citation

Burden of Hospitalized Pneumonia and Its Clinical Characteristics in Korea COPD Population: A Prospective, Multi-center, Cohort Study

Typeobservational_patient_registrySponsorChung-Ang University HospitalRan2017 to 2019Enrolled384ConditionsCOPD, Pneumonia, Pneumococcal VaccineArmsPCV13
3 · Its place in the literature

Who cites it

185 citing papers in PubMed, 8 syntheses or guidelines pooled it, 444 citations in OpenAlex.

  1. Pooled it
  2. Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD.European respiratory review : an official journal of the European Respiratory Society · 2021
    Pooled it
  3. Pooled it
  4. Inhaled corticosteroids and FEVRespiratory research · 2019
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Observational
  19. Review
  20. Article

125 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Samy SuissaDepartments of Epidemiology and Biostatistics and of Medicine, Center for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, McGill University, , Montreal, Québec, Canada.
Valérie Patenaude
Francesco Lapi
Pierre Ernst
McGill University · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

backgroundInhaled corticosteroids (ICS) are known to increase the risk of pneumonia in patients with chronic obstructive pulmonary disease (COPD). It is unclear whether the risk of pneumonia varies for different inhaled agents, particularly fluticasone and budesonide, and increases with the dose and long-term duration of use.

methodsWe formed a new-user cohort of patients with COPD treated during 1990-2005. Subjects were identified using the Quebec health insurance databases and followed through 2007 or until a serious pneumonia event, defined as a first hospitalisation for or death from pneumonia. A nested case-control analysis was used to estimate the rate ratio (RR) of serious pneumonia associated with current ICS use, adjusted for age, sex, respiratory disease severity and comorbidity.

resultsThe cohort included 163 514 patients, of which 20 344 had a serious pneumonia event during the 5.4 years of follow-up (incidence rate 2.4/100/year). Current use of ICS was associated with a 69% increase in the rate of serious pneumonia (RR 1.69; 95% CI 1.63 to 1.75). The risk was sustained with long-term use and declined gradually after stopping ICS use, disappearing after 6 months (RR 1.08; 95% CI 0.99 to 1.17). The rate of serious pneumonia was higher with fluticasone (RR 2.01; 95% CI 1.93 to 2.10), increasing with the daily dose, but was much lower with budesonide (RR 1.17; 95% CI 1.09 to 1.26).

conclusionsICS use by patients with COPD increases the risk of serious pneumonia. The risk is particularly elevated and dose related with fluticasone. While residual confounding cannot be ruled out, the results are consistent with those from recent randomised trials.

Indexed as

Administration, InhalationAgedDose-Response Relationship, DrugFemaleFollow-Up StudiesGlucocorticoidsHumansIncidenceMaleMiddle AgedPneumoniaPulmonary Disease, Chronic ObstructiveQuebecRetrospective StudiesRisk FactorsTime FactorsGlucocorticoids

Identifiers

PMID24130228
PMCPMC3812880
OpenAlexW2133986277

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.