흡입스테로이드제와 흡입지속성베타작용제의 복합제 사용에서 폐렴 발생위험비교를 위한 코호트 연구
Risk of Pneumonia Associated with the Use of ICS/LABA: A Retrospective Cohort Study in Korea
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Objectives: The purpose of this study is to compare the risk of hospitalization by pneumonia between two different inhaled corticosteroid (ICS)/long-acting beta2-agonist (LABA) substances. Methods: Retrospective cohort study was conducted using 2013 National Patients Sample of Health Insurance Review and Assessment Service (HIRA-NPS) database. The cohort consisted of the patients who are prescribed dry powder inhaler form of fluticasone/salmeterol and budesonide/formoterol at least once (28 days) from Feb 2013 to Dec 2013 and who had no record of prescription of ICS/LABA one month prior to the index date. The patients who were enrolled to the cohort was observed until the first hospitalization due to pneumonia (J12-18 of International Classification of Diseases-10 code) occurrence. The incidence rate of pneumonia were estimated and crude and adjusted hazard ratio of pneumonia associated with ICS/LABA use with 95% CIs were estimated by Cox regression model. Results: The cohort included 5597 patients of which 4274 patients (76.4%) treated with fluticasone/salmeterol and 1323 patients (23.6%) treated with budesonide/formoterol. The pneumonia incidence rate was higher with fluticasone/salmeterol which was 8.16 per 100 person-year while the pneumonia incidence rate of budesonide/formoterol was 5.04 per 100 person-year. Compared with budesonide/formoterol, the pneumonia risk was higher in patients treated with fluticasone/salmeterol (hazard ratio: 1.46, 95% CI: 1.04−2.04). Conclusion: The higher risk of pneumonia occurrence was observed for fluticasone/salmeterol which shows the intra-class difference of fixed combination of inhaled corticosteroid/long acting beta-2 agonist.
Abstract
Objectives: The purpose of this study is to compare the risk of hospitalization by pneumonia between two different inhaled corticosteroid (ICS)/long-acting beta2-agonist (LABA) substances. Methods: Retrospective cohort study was conducted using 2013 National Patients Sample of Health Insurance Review and Assessment Service (HIRA-NPS) database. The cohort consisted of the patients who are prescribed dry powder inhaler form of fluticasone/salmeterol and budesonide/formoterol at least once (28 days) from Feb 2013 to Dec 2013 and who had no record of prescription of ICS/LABA one month prior to the index date. The patients who were enrolled to the cohort was observed until the first hospitalization due to pneumonia (J12-18 of International Classification of Diseases-10 code) occurrence. The incidence rate of pneumonia were estimated and crude and adjusted hazard ratio of pneumonia associated with ICS/LABA use with 95% CIs were estimated by Cox regression model. Results: The cohort included 5597 patients of which 4274 patients (76.4%) treated with fluticasone/salmeterol and 1323 patients (23.6%) treated with budesonide/formoterol. The pneumonia incidence rate was higher with fluticasone/salmeterol which was 8.16 per 100 person-year while the pneumonia incidence rate of budesonide/formoterol was 5.04 per 100 person-year. Compared with budesonide/formoterol, the pneumonia risk was higher in patients treated with fluticasone/salmeterol (hazard ratio: 1.46, 95% CI: 1.04−2.04). Conclusion: The higher risk of pneumonia occurrence was observed for fluticasone/salmeterol which shows the intra-class difference of fixed combination of inhaled corticosteroid/long acting beta-2 agonist.
참고문헌 (12)
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