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Inhaled Corticosteroids Boost Pneumonia Risk in COPD


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Singh noted that the finding means that about one in every 47 people with COPD who uses a corticosteroid inhaler for a year is likely to develop pneumonia linked to use of the drug.

People should discuss the risks and benefits of the drugs with their doctor, Singh said. "You have to balance the risks, and, unfortunately, there are few options for patients with COPD."

COPD is a progressive, destructive disease of the lungs, usually brought on by smoking. There is no known cure. Symptoms include restricted breathing, secretion of mucus, oxidative stress and airway inflammation.

Text Continues Below



COPD is the fourth-leading cause of death in the United States, accounting for more than 120,000 deaths each year, according to the National Lung Health Education Program. It is estimated that as many as 24 million Americans have COPD, and the number is rising rapidly.

Katie Neff, a spokeswoman for AstraZeneca, noted that Symbicort is not currently indicated for the treatment of COPD, although the company is looking for the U.S. Food and Drug Administration to approve its use for the condition. In addition, she said, results from trials of the product involving people with COPD found no increase in pneumonia.

"Data from SHINE and SUN [two studies that looked at the drug in COPD patients] demonstrated that Symbicort was well-tolerated for six and 12 months respectively," Neff said. "The incidence of pneumonia-related adverse events was no different for the Symbicort-treatment arms compared to placebo."

Patty Johnson, a spokeswoman for GlaxoSmithKline, disagreed with the contention that Advair does not benefit people with COPD.

"The benefits of Advair for treating patients with COPD have clearly been established," Johnson said. "Advair reduces exacerbations of COPD by 30 percent."

Johnson noted that the finding that Advair increases the risk of pneumonia has been known and is covered on the product's package label and patient information insert. "Physicians need to look at the total benefit/risk profile for the product for all their patients," she said.

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Last updated 2/9/2009

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SOURCES: Sonal Singh, M.D., M.P.H., assistant professor, internal medicine, Wake Forest University Baptist Medical Center, Winston-Salem, N.C.; Norman Edelman, M.D., chief medical officer, American Lung Association, New York City; Katie Neff, spokeswoman, AstraZeneca, Wilmington, Del.; Patty Johnson, spokeswoman, GlaxoSmithKline, Philadelphia; Feb. 9, 2009, Archives of Internal Medicine


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