Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids

Autor: Tsan-Ming Huang, Kuan-Chih Kuo, Ya-Hui Wang, Cheng-Yi Wang, Chih-Cheng Lai, Hao-Chien Wang, Likwang Chen, Chong-Jen Yu, On the behalf of Taiwan Clinical Trial Consortium for Respiratory Diseases (TCORE)
Rok vydání: 2020
Předmět:
Male
Budesonide
Pulmonary Disease
Chronic Obstructive
0302 clinical medicine
immune system diseases
Adrenal Cortex Hormones
Risk Factors
Budesonide
Formoterol Fumarate Drug Combination
Medicine
030212 general & internal medicine
Fluticasone
education.field_of_study
COPD
Incidence
respiratory system
Middle Aged
Fluticasone-Salmeterol Drug Combination
Infectious Diseases
Fluticasone/salmeterol
Female
Salmeterol
hormones
hormone substitutes
and hormone antagonists
circulatory and respiratory physiology
Research Article
medicine.drug
medicine.medical_specialty
Population
Taiwan
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Internal medicine
Statistical significance
Administration
Inhalation
Tuberculosis
Humans
lcsh:RC109-216
Propensity Score
education
Budesonide/formoterol
Adrenergic beta-2 Receptor Agonists
Aged
business.industry
Mycobacterium tuberculosis
medicine.disease
respiratory tract diseases
030228 respiratory system
Formoterol
business
Follow-Up Studies
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-8 (2020)
ISSN: 1471-2334
Popis: Objectives To investigate the incidence of active tuberculosis (TB) among COPD patients using fluticasone/salmeterol or budesonide/formoterol, and to identify any differences between these two groups of patients. Methods The study enrolled COPD patients from Taiwan NHIRD who received treatment with fluticasone/salmeterol or budesonide/formoterol for > 90 days between 2004 and 2011. The incidence of active TB was the primary outcome. Results Among the intention-to-treat population prior to matching, the incidence rates of active TB were 0.94 and 0.61% in the fluticasone/salmeterol and budesonide/formoterol groups, respectively. After matching, the fluticasone/salmeterol group had significantly higher rates of active TB (adjusted HR, 1.41, 95% CI, 1.17–1.70) compared with the budesonide/formoterol group. The significant difference between these two groups remained after a competing risk analysis (HR, 1.45, 95% CI, 1.21–1.74). Following propensity score matching, the fluticasone/salmeterol group had significantly higher rates of active TB compared with the budesonide/formoterol group (adjusted HR, 1.45, 95% CI, 1.14–1.85). A similar trend was observed after a competing risk analysis (HR, 1.44, 95% CI, 1.19–1.75). A higher risk of active TB was observed in the fluticasone/salmeterol group compared with the budesonide/formoterol group across all subgroups, but some differences did not reach statistical significance. Conclusion Fluticasone/salmeterol carried a higher risk of active TB compared with budesonide/formoterol among COPD patients.
Databáze: OpenAIRE
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