Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids
Journal
BMC Infectious Diseases
Journal Volume
20
Journal Issue
1
Pages
706
Date Issued
2020
Author(s)
Abstract
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. ? 2020 The Author(s).
SDGs
Other Subjects
budesonide plus formoterol; fluticasone propionate plus salmeterol; beta 2 adrenergic receptor stimulating agent; budesonide plus formoterol; corticosteroid; fluticasone propionate plus salmeterol; adult; aged; Article; chronic obstructive lung disease; cohort analysis; controlled study; female; human; incidence; infection risk; intention to treat analysis; major clinical study; male; outcome assessment; propensity score; risk assessment; statistical significance; Taiwan; trend study; tuberculosis; chronic obstructive lung disease; follow up; inhalational drug administration; middle aged; Mycobacterium tuberculosis; risk factor; tuberculosis; Administration, Inhalation; Adrenal Cortex Hormones; Adrenergic beta-2 Receptor Agonists; Aged; Budesonide, Formoterol Fumarate Drug Combination; Female; Fluticasone-Salmeterol Drug Combination; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Mycobacterium tuberculosis; Propensity Score; Pulmonary Disease, Chronic Obstructive; Risk Factors; Taiwan; Tuberculosis
Publisher
BioMed Central Ltd
Type
journal article