Evidence map›Paper›PMID 37419145›Full record

ArticleChest2023

The Effect of Inhaled Corticosteroids on Pneumonia Risk in Patients With COPD-Bronchiectasis Overlap: A UK Population-Based Case-Control Study.

Andrew I Ritchie, Aran Singayagam, Sebastian Mitchell, Jadwiga A Wedzicha, Anand Shah, Chloë I Bloom

Erratum issuedOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% 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.

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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Article
  4. Clinical Implications ofChronic obstructive pulmonary diseases (Miami, Fla.) · 2025
    Article
  5. Review
  6. Article
  7. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Andrew I RitchieNational Heart and Lung Institute, Imperial College London, London, England.
Aran SingayagamNational Heart and Lung Institute, Imperial College London, London, England; Department of Infectious Disease, Imperial College London, London, England.
Sebastian MitchellNational Heart and Lung Institute, Imperial College London, London, England.
Jadwiga A WedzichaNational Heart and Lung Institute, Imperial College London, London, England.
Anand ShahDepartment of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, England; Royal Brompton Hospital, Guys and St. Thomas' NHS Foundation Trust, London, England.
Chloë I BloomNational Heart and Lung Institute, Imperial College London, London, England; Imperial College Healthcare NHS Trust, London, England. Electronic address: chloe.bloom06@imperial.ac.uk.
Lung Institute · USGuy's and St Thomas' NHS Foundation Trust · GBImperial College Healthcare NHS Trust · GB

Funding

Department of HealthMedical Research Council G0800570Medical Research Council G1001365
6 · The paper itself

Abstract

backgroundInhaled corticosteroids (ICS) increase the risk of pneumonia in COPD and commonly are used in patients with COPD-bronchiectasis overlap. RESEARCH QUESTION: Is the risk of pneumonia associated with ICS further heightened in COPD-bronchiectasis? STUDY DESIGN AND

methodsElectronic health care records (from 2004-2019) were used to obtain a cohort of patients with COPD and a nested case-control group (age and sex matched 1:4). Analyses were conducted to determine the risk of hospitalization for pneumonia in COPD associated with ICS use in those with bronchiectasis. Findings were confirmed by several sensitivity analyses. Additionally, a smaller nested case-control group containing only patients with COPD-bronchiectasis overlap and those with recent blood eosinophil counts (BECs) was used to determine any association with BEC.

resultsThree hundred sixteen thousand six hundred sixty-three patients were eligible for the COPD cohort; bronchiectasis significantly increased the risk of pneumonia (adjusted hazard ratio, 1.24; 95% CI, 1.15-1.33). In the first nested case-control group of 84,316 patients with COPD, ICS was found to increase the odds of pneumonia (adjusted OR [AOR], 1.26; 95% CI, 1.19-1.32) only if used in the previous 180 days. However, bronchiectasis was a significant modifier such that ICS use did not augment further the already elevated bronchiectasis-associated pneumonia risk (COPD-bronchiectasis: AOR, 1.01; 95% CI, 0.8-1.28; no bronchiectasis: AOR, 1.27; 95% CI, 1.20-1.34). Several sensitivity analyses and a second smaller nested case-control group confirmed these findings. Finally, we found that BEC modified the ICS-associated pneumonia risk in COPD-bronchiectasis overlap, where lower BEC was associated significantly with pneumonia (BEC ≤ 3 × 10

interpretationICS use does not augment further the already increased risk of hospitalization for pneumonia associated with concomitant bronchiectasis in patients with COPD.

Indexed as

BronchiectasisGlucocorticoidsPneumoniaPulmonary Disease, Chronic ObstructiveAdministration, InhalationCase-Control StudiesEnglandHumansRetrospective StudiesUnited KingdomGlucocorticoidsbronchiectasisCOPDinhaled corticosteroidpneumonia

Identifiers

PMID37419145
PMCPMC10808068
OpenAlexW4381033620

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.