SynthesisCOPD2016
Association of Inhaled Corticosteroids with Incident Pneumonia and Mortality in COPD Patients; Systematic Review and Meta-Analysis.
Synthesis in COPD, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Inhaled corticosteroids for bronchiectasis.The Cochrane database of systematic reviews · 2018Pooled it
- Comparison of the Risk of Pneumonia Between Fluticasone Furoate/Umeclidinium/Vilanterol and Multiple-Inhaler Triple Therapy in Patients with COPD Using Health Insurance Claims Data: Final Analysis of Post-Marketing Database Surveillance in Japan.Journal of clinical medicine · 2025Article
- Paradigm Shift in the Treatment of Chronic Obstructive Pulmonary Disease Improves Patient Outcomes.International journal of chronic obstructive pulmonary disease · 2025Article
- Survival benefit of inhaled corticosteroids in patients with chronic obstructive pulmonary disease: a nationwide cohort study.Scientific reports · 2024Article
- Inhaled corticosteroid treatment and pneumonia in patients with chronic obstructive pulmonary disease - nationwide development from 1998 to 2018.European clinical respiratory journal · 2024Article
- Risk of Pneumonia in Patients with COPD Initiating Fixed Dose Inhaled Corticosteroid (ICS) / Long-Acting Bronchodilator (LABD) Formulations Containing Extrafine Beclometasone Dipropionate versus Patients Initiating LABD Without ICS.Pragmatic and observational research · 2024Article
- Inhaled corticosteroids and adverse outcomes among chronic obstructive pulmonary disease patients with community-acquired pneumonia: a population-based cohort study.Frontiers in medicine · 2023Article
- Effects of Inhaled Corticosteroids on the Innate Immunological Response toInternational journal of molecular sciences · 2022Article
- Risk of Tuberculosis Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Study.Journal of personalized medicine · 2022Article
- Chronic use of inhaled corticosteroids in patients admitted for respiratory virus infections: a 6-year prospective multicenter study.Scientific reports · 2022Article
- Inhaled corticosteroid dose is associated withBMJ open respiratory research · 2021Article
- Inhaled Corticosteroids and the Pneumonia Risk in Patients With Chronic Obstructive Pulmonary Disease: A Meta-analysis of Randomized Controlled Trials.Frontiers in pharmacology · 2021Review
- Influence of Comorbidities and Airway Clearance on Mortality and Outcomes of Patients With Severe Bronchiectasis Exacerbations in Taiwan.Frontiers in medicine · 2021Article
- Treatment with inhaled corticosteroids in chronic obstructive pulmonary disease.Journal of thoracic disease · 2020Review
- Article
- Treatment of COPD: the simplicity is a resolved complexity.Multidisciplinary respiratory medicine · 2019Article
- Incidence of Respiratory Complications Following Lumbar Spine Surgery.International journal of spine surgery · 2018Article
- The IMPACT of tripleBreathe (Sheffield, England) · 2018Article
- Identifying the associated risks of pneumonia in COPD patients: ARCTIC an observational study.Respiratory research · 2018Observational
- Inhaled therapies in patients with moderate COPD in clinical practice: current thinking.International journal of chronic obstructive pulmonary disease · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundInhaled corticosteroids are commonly prescribed for patients with severe COPD. They have been associated with increased risk of pneumonia but not with increased pneumonia-associated or overall mortality.
methodsTo further examine the effects of inhaled corticosteroids on pneumonia incidence, and mortality in COPD patients, we searched for potentially relevant articles in PubMed, Medline, CENTRAL, EMBASE, Scopus, Web of Science and manufacturers' web clinical trial registries from 1994 to February 4, 2014. Additionally, we checked the included and excluded studies' bibliographies. We subsequently performed systematic review and meta-analysis of included randomized controlled trials and observational studies on the topic.
resultsWe identified 38 studies: 29 randomized controlled trials and nine observational studies. The estimated unadjusted risk of pneumonia was increased in randomized trials: RR 1.61; 95% CI 1.35-1.93, p < 0.001; as well as in observational studies: OR 1.89; 95% CI 1.39-2.58, p < 0·001. Six randomized trials and seven observational studies were useful in estimating unadjusted risk of pneumonia -case-fatality: RR 0.91; 95% CI 0.52-1.59, p = 0.74; and OR 0.72; 95% CI 0.59-0.88, p = 0.001, respectively. Twenty-nine randomized trials and six observational studies allowed estimation of unadjusted risk of overall mortality: RR 0.95; 95% CI 0.85-1.05, p = 0.31; and OR 0.79; 95% CI 0.65-0.97, p = 0.02, respectively.
conclusionsDespite a substantial and significant increase in unadjusted risk of pneumonia associated with inhaled corticosteroid use, pneumonia fatality and overall mortality were found not to be increased in randomized controlled trials and were decreased in observational studies.
Indexed as
Identifiers
What OpenQuestion holds
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.