Crude and adjusted rate ratios of serious pneumonia associated with current use, dose and past use of inhaled corticosteroids among patients with COPD
| Inhaled corticosteroid exposure | Pneumonia cases | Controls | Crude rate ratio | Adjusted* rate ratio | 95% CI |
|---|---|---|---|---|---|
| Number of subjects | 20 344 | 197 705 | |||
| No use in the year prior to index date, % | 46.47 | 61.15 | 1.00 | 1.00 | Reference |
| Current use, %† | 37.53 | 22.01 | 2.30 | 1.69 | 1.63 to 1.75 |
| Low dose‡ | 3.12 | 2.72 | 1.50 | 1.24 | 1.13 to 1.36 |
| Medium dose | 16.28 | 10.28 | 2.15 | 1.66 | 1.59 to 1.74 |
| High dose | 18.14 | 9.01 | 2.73 | 1.86 | 1.77 to 1.94 |
| Past use, % | 16.00 | 16.84 | 1.28 | 1.15 | 1.10 to 1.20 |
| Time since stopping, % | |||||
| 61–180 days | 9.95 | 9.96 | 1.35 | 1.19 | 1.13 to 1.26 |
| 181–270 days | 3.29 | 3.76 | 1.17 | 1.08 | 0.99 to 1.17 |
| 271–365 days | 2.76 | 3.11 | 1.19 | 1.08 | 0.99 to 1.18 |
*Adjusted for all of the factors listed in table 1.
†Current use refers to a prescription of any one of inhaled fluticasone, budesonide, beclomethasone, flunisolide or triamcinolone in the 60 days prior to the index date.
‡Current daily dose in fluticasone equivalents, in μg/day; high: 1000 or more; moderate: 500–999; low: less than 500.
COPD, chronic obstructive pulmonary disease.