In clinical trials, the use of inhaled corticosteroids is associated with an increased risk of pneumonia in people with COPD, but whether the same is true for people with asthma is not known.
With the use of primary care data from The Health Improvement Network, researchers have identified people with asthma, and from this cohort, they have selected patients with pneumonia or lower respiratory tract infection and age- and sex-matched control subjects.
A dose-response relationship was found between the strength of inhaled corticosteroid dose and risk of pneumonia or lower respiratory tract infection ( P less than 0.001 for trend ) such that after adjusting for confounders, people receiving the highest strength of inhaled corticosteroid ( greater than or equal to 1000 mcg ) had a 2.04 increased risk of pneumonia or lower respiratory tract infection compared with those with asthma who did not have a prescription for inhaled corticosteroids within the previous 90 days.
In conclusion, people with asthma receiving inhaled corticosteroids are at an increased risk of pneumonia or lower respiratory infection, with those receiving higher doses being at greater risk.
Pneumonia should be considered as a possible side effect of inhaled corticosteroids, and the lowest possible dose of inhaled corticosteroids should be used in the management of asthma. ( Xagena )
McKeever T et al, Chest 2013;144:1788-1794