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Patients Taking Inhaled Steroids may Develop Pneumonia

orticosteroids in patients with COPD, the authors said, are particularly troublesome given the limited evidence for their efficacy.

In an accompanying editorial, Mark Woodhead, D.M, of Manchester (U.K.) Royal Infirmary, wrote that this report confirms secondary findings from a prospective, placebo-controlled study of an inhaled corticosteroid with long-acting antagonist that was recently published.

Given that this earlier study was not designed to analyze pneumonia frequency, its small size and high drop-out rate, he suggested, might lead a reader to reasonably conclude that its pneumonia findings were spurious.

Now, with the addition of the Canadian population-based study, Dr. Woodhead wrote, the unexpected conclusion--that drugs prescribed to prevent COPD exacerbations put patients at greater risk for severe pneumoniadeserves further consideration and study through large prospective studies with objective pneumonia definitions.

The finding of an association, he said, between pneumonia frequency and inhaled corticosteroid use in studies of different design, in different populations, and with evidence of a dose-response relations means that the findings may be real and that these observations cannot simply be dismissed.


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