Drugs May Rob Breath, Not Save It

(Ivanhoe Newswire) -- Drugs meant to keep people breathing easier may actually be putting them at increased risk of dying from pneumonia.

Canadian investigators who studied more than 175,000 people with chronic obstructive pulmonary disease, or COPD, found those on inhaled steroids were significantly more likely to be hospitalized with pneumonia and, most importantly, significantly more likely to have a severe form of the disease leading to death.

The drugs upped the overall pneumonia hospitalization rate by 70 percent. They increased the likelihood of dying within 30 days of a pneumonia hospitalization by 53 percent. People taking higher doses of the medications were the most affected.

These findings are troublesome, report the researchers, because inhaled steroid use among COPD patients has risen markedly over the past 20 years. In 1987, about 13 percent of COPD patients were taking the drugs. By 1995, that figure had risen to more than 41 percent.

The researchers aren't sure how inhaled steroids, which reduce inflammation in the airways, ostensibly allowing for better airflow and thus better breathing, could be contributing to pneumonia, especially since they do reduce overall flare-ups of the disease. But a fellow investigator writing in an accompanying editorial believes the association, while surprising, is real, noting previous studies have also suggested at such a link.

"The finding of an association between pneumonia frequency and inhaled corticosteroid use in studies of different design, in different populations, and with evidence of a dose–response relationship means that the findings may be real and that these observations cannot simply be dismissed," writes Mark Woodhead, D.M., from the Manchester Royal Infirmary in Manchester, United Kingdom.

"The issue requires prospective evaluation in further large studies of inhaled corticosteroids using objective pneumonia definitions. Maybe more surprises await us?"

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SOURCE: American Journal of Respiratory and Critical Care Medicine, published online July 16, 2007