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Table 2 Risk of pneumonia by type of ICS in permanent users

From: Concomitant inhaled corticosteroid use and the risk of pneumonia in COPD: a matched-subgroup post hoc analysis of the UPLIFT® trial

 

Treatment throughout study

Comparison

FP

Other ICS

No ICS

FP versus other ICS

HR* or RR (95% CI);

p-value

FP versus no ICS

HR* or RR (95% CI);

p-value

Other ICS versus no ICS

HR* or RR (95% CI);

p-value

Permanent users, n

825

825

825

Patients with pneumonia events, n (%)#

115 (13.9)

95 (11.5)

87 (10.5)

HR 1.28

(0.97, 1.68);

p = 0.078

HR 1.33

(1.00, 1.75);

p = 0.046

HR 1.03

(0.77, 1.38);

p = 0.830

Pneumonia events, n

159

111

98

Adjusted rate of pneumonia events (per patient-year), mean (95% CI)

0.10

(0.07, 0.14)

0.07

(0.04, 0.10)

0.06

(0.04, 0.10)

RR 1.48

(1.00, 2.19);

p = 0.049

RR 1.58

(1.05, 2.37);

p = 0.028

RR 1.07

(0.69, 1.65);

p = 0.773

Patients with hospitalized pneumonia events, n (%)

65 (7.9)

55 (6.7)

49 (5.9)

HR 1.24

(0.86, 1.77);

p = 0.249

HR 1.30

(0.90, 1.88);

p = 0.168

HR 1.05

(0.71, 1.54);

p = 0.802

Hospitalized pneumonia events, n

78

64

51

Adjusted rate of hospitalized pneumonia events (per patient-year), mean (95% CI)

0.05

(0.03, 0.08)

0.04

(0.03, 0.07)

0.04

(0.02, 0.06)

RR 1.25

(0.78, 2.02);

p = 0.355

RR 1.47

(0.88, 2.44);

p = 0.141

RR 1.17

(0.69, 1.99);

p = 0.560

Patients with pneumonia resulting in death, n (%)

7 (0.85)

13 (1.58)

9 (1.09)

HR 0.54

(0.22, 1.36);

p = 0.194

HR 0.75

(0.28, 2.01);

p = 0.567

HR 1.38

(0.59, 3.23);

p = 0.460

  1. Abbreviations: CI confidence interval, FEV1 forced expiratory volume in 1 s, FP fluticasone propionate, GOLD Global Initiative for Chronic Obstructive Lung Disease, HR hazard ratio, ICS inhaled corticosteroid, RR rate ratio. Matched-subgroup population. *Cox regression analysis with ICS use on-treatment and matching factors as covariates. Poisson regression with ICS use on-treatment and matching factors (age, FEV1% predicted, GOLD stage, emphysema diagnosis, and courses of antibiotics) as covariates. #In this analysis, 23 patients treated permanently with FP received the treatment for non-pulmonary (mostly nasal) indication only; three of these patients had a pneumonia event during the study. In the subgroup permanently treated with other ICS, these numbers were 10 and 3, respectively