Observational studyInternational journal of chronic obstructive pulmonary disease2017
Severe exacerbation and pneumonia in COPD patients treated with fixed combinations of inhaled corticosteroid and long-acting beta2 agonist.
Observational study in International journal of chronic obstructive pulmonary disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- 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 · 2021Pooled it
- Intraclass Difference in Pneumonia Risk with Fluticasone and Budesonide in COPD: A Systematic Review of Evidence from Direct-Comparison Studies.International journal of chronic obstructive pulmonary disease · 2020Pooled it
- Comparing Pneumonia Risks of Budesonide with Fluticasone Among Patients with Asthma in Hong Kong: A Territory-Wide Retrospective Study.Advances in therapy · 2026Article
- A prevalence study focusing on hospitalized COPD related pulmonary hypertension.Scientific reports · 2025Article
- High-risk adverse events in two types of single inhaler triple-therapy: a pharmacovigilance study based on the FAERS database.Frontiers in pharmacology · 2024Article
- Real-World Evidence: Bridging Gaps in Evidence to Guide Payer Decisions.PharmacoEconomics - open · 2021Article
- Response to the Letter to the Editor Regarding "Intraclass Difference in Pneumonia Risk with Fluticasone and Budesonide in COPD: A Systematic Review of Evidence from Direct-Comparison Studies" [Response to Letter].International journal of chronic obstructive pulmonary disease · 2021Article
- Treatment with inhaled corticosteroids in chronic obstructive pulmonary disease.Journal of thoracic disease · 2020Review
- Asthma and treatment with inhaled corticosteroids: associations with hospitalisations with pneumonia.BMC pulmonary medicine · 2019Article
- Journal Club-- COPD Exacerbations and Gastroesophageal Reflux Disease: Why Proton Pump Inhibitor Therapy is Not Enough.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2019Article
- The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study.Journal of clinical medicine · 2018Article
- Identifying the associated risks of pneumonia in COPD patients: ARCTIC an observational study.Respiratory research · 2018Observational
- Inhaled corticosteroids for chronic obstructive pulmonary disease: what is their role in therapy?International journal of chronic obstructive pulmonary disease · 2018Review
- Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the risk of pneumonia and severe exacerbations in patients with COPD.International journal of chronic obstructive pulmonary disease · 2018Article
- Trends in health care resource utilization and pharmacological management of COPD in Taiwan from 2004 to 2010.International journal of chronic obstructive pulmonary disease · 2017Article
- Comparison of fluticasone propionate and budesonide on COPD macrophage and neutrophil function.International journal of chronic obstructive pulmonary diseaseArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt remains unclear whether severe exacerbation and pneumonia of COPD differs between patients treated with budesonide/formoterol and those treated with fluticasone/salmeterol. Therefore, we conducted a comparative study of those who used budesonide/formoterol and those treated with fluticasone/salmeterol for COPD.
methodsSubjects in this population-based cohort study comprised patients with COPD who were treated with a fixed combination of budesonide/formoterol or fluticasone/salmeterol. All patients were recruited from the Taiwan National Health Insurance database. The outcomes including severe exacerbations, pneumonia, and pneumonia requiring mechanical ventilation (MV) were measured.
resultsDuring the study period, 11,519 COPD patients receiving fluticasone/salmeterol and 7,437 patients receiving budesonide/formoterol were enrolled in the study. Pairwise matching (1:1) of fluticasone/salmeterol and budesonide/formoterol populations resulted in to two similar subgroups comprising each 7,295 patients. Patients receiving fluticasone/salmeterol had higher annual rate and higher risk of severe exacerbation than patients receiving budesonide/formoterol (1.2219/year vs 1.1237/year, adjusted rate ratio, 1.08; 95% CI, 1.07-1.10). In addition, patients receiving fluticasone/salmeterol had higher incidence rate and higher risk of pneumonia than patients receiving budesonide/formoterol (12.11 per 100 person-years vs 10.65 per 100 person-years, adjusted hazard ratio [aHR], 1.13; 95% CI, 1.08-1.20). Finally, patients receiving fluticasone/salmeterol had higher incidence rate and higher risk of pneumonia requiring MV than patients receiving budesonide/formoterol (3.94 per 100 person-years vs 3.47 per 100 person-years, aHR, 1.14; 95% CI, 1.05-1.24). A similar trend was seen before and after propensity score matching analysis, intention-to-treat, and as-treated analysis with and without competing risk.
conclusionsBased on this retrospective observational study, long-term treatment with fixed combination budesonide/formoterol was associated with fewer severe exacerbations, pneumonia, and pneumonia requiring MV than fluticasone/salmeterol in COPD patients.
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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.