Do Inhaled Corticosteroids Reduce Hospitalizations Among Older Adults With Asthma, COPD?

Older adults with asthma or concurrent asthma and chronic obstructive pulmonary disease (COPD)—but not COPD alone—are less likely to be hospitalized for obstructive lung disease if they take an inhaled corticosteroid, according to a new study.

To evaluate the effectiveness and safety of inhaled corticosteroids in older adults with asthma and/or COPD, the researchers retrospectively analyzed data on individuals aged 66 years or older from Ontario, Canada, who had met a validated case definition of physician-diagnosed COPD and/or asthma between 2003 and 2014. 

The patients—who were followed until March 2015—had all been exposed to a new inhaled corticosteroid during the study period. The researchers measured the effectiveness of inhaled corticosteroids using rates of hospitalizations for obstructive lung disease and measured the medication’s safety using rates of hospitalizations for pneumonia.

Of the 87,690 patients with asthma, 27% had concurrent COPD. Of the 150,593 individuals with COPD, 25% had concurrent asthma.

After controlling for confounders, the researchers determined that inhaled corticosteroids were associated with fewer hospitalizations for obstructive lung disease in patients with asthma alone. Concurrent COPD attenuated the benefit. A similar association was observed in those with COPD and concurrent asthma but not in those with COPD alone.

Further, individuals with COPD alone had a marginally increased risk of pneumonia hospitalizations with their receipt of inhaled corticosteroids. This association was not present among the other patient groups. 

—Colleen Murphy

Reference:

Kendzerska T, Aaron SD, To T, et al; Canadian Respiratory Research Network. Effectiveness and safety of inhaled corticosteroids in older individuals with chronic obstructive pulmonary disease and/or asthma. A population study. Ann Am Thorac Soc. 2019;16(10). doi:10.1513/AnnalsATS.201902-126OC.