Association between Increased Risk of Pneumonia with ICS in COPD: A Continuous Variable Analysis of Patient Factors from the IMPACT Study

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dc.authoridAggarwal, Bhumika/0000-0002-8370-9319
dc.contributor.authorAggarwal, Bhumika
dc.contributor.authorJones, Paul
dc.contributor.authorCasas, Alejandro
dc.contributor.authorGomes, Mauro
dc.contributor.authorJuthong, Siwasak
dc.contributor.authorLitewka, Diego
dc.contributor.authorOng-Dela Cruz, Bernice
dc.date.accessioned2024-08-31T07:50:58Z
dc.date.available2024-08-31T07:50:58Z
dc.date.issued2024
dc.departmentEge Üniversitesien_US
dc.description.abstractIntroduction: Despite the proven benefits of inhaled corticosteroid (ICS)-containing triple therapy for chronic obstructive pulmonary disease (COPD), clinicians limit patient exposure to ICS due to the risk of pneumonia. However, there are multiple factors associated with the risk of pneumonia in patients with COPD. This post hoc analysis of IMPACT trial data aims to set the risks associated with ICS into a context of specific patient-related factors that contribute to the risk of pneumonia. Methods: The 52-week, double-blind IMPACT trial randomized patients with symptomatic COPD and >= 1 exacerbation in the prior year 2:2:1 to once-daily fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI), FF/VI or UMEC/VI. Annual rate of on-treatment pneumonias in the intent-to-treat population associated with age, body mass index (BMI), percent predicted forced expiratory volume in 1 s (FEV1) and blood eosinophil count (BEC) was evaluated. Results: This analysis revealed that the annual rate of pneumonia showed the lowest risk at the age of 50 years. The 95% confidence intervals (CI) between ICS-containing and non-ICS containing treatments diverged in ages > 63 years, suggesting a significantly increased ICS-related risk in older patients. In contrast, the annual rate of pneumonia rose in both groups below BMI of 22.5 kg/m(2), but above that, there was no relationship to pneumonia rate and no differential effect between the two groups. The relationship between BEC and pneumonia was flat up to > 300/mu L cells with ICS-containing treatment and then rose. In contrast, the rate of pneumonia with non-ICS containing treatment appeared to increase at a lower level of BEC (similar to 200/mu L). Conclusions: There was little evidence of a differential effect of older age, lower BMI, lower FEV1 and BEC on the pneumonia rate between ICS-containing and non-ICS containing treatments. This analysis points to the need for a balanced approach to risk versus benefit in the use of ICS-containing treatments in COPD.en_US
dc.description.sponsorshipGSK; Costello Medical, UK - GSKen_US
dc.description.sponsorshipEVERSANA provided medical writing and editorial support; Costello Medical, UK provided publication coordination and was funded by GSK.en_US
dc.identifier.doi10.1007/s41030-024-00255-1
dc.identifier.endpage192en_US
dc.identifier.issn2364-1754
dc.identifier.issn2364-1746
dc.identifier.issue2en_US
dc.identifier.pmid38446336en_US
dc.identifier.scopus2-s2.0-85186545760en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage183en_US
dc.identifier.urihttps://doi.org/10.1007/s41030-024-00255-1
dc.identifier.urihttps://hdl.handle.net/11454/105452
dc.identifier.volume10en_US
dc.identifier.wosWOS:001179528500002en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringernatureen_US
dc.relation.ispartofPulmonary Therapyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240831_Uen_US
dc.subjectImpacten_US
dc.subjectPost Hoc Analysisen_US
dc.subjectPneumonia Risken_US
dc.subjectCopden_US
dc.subjectIcsen_US
dc.titleAssociation between Increased Risk of Pneumonia with ICS in COPD: A Continuous Variable Analysis of Patient Factors from the IMPACT Studyen_US
dc.typeArticleen_US

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