학술논문
Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids
Document Type
Academic Journal
Author
Huang, Tsan-Ming; Kuo, Kuan-Chih; Wang, Ya-Hui; Wang, Cheng-Yi; Lai, Chih-Cheng; Wang, Hao-Chien; Chen, Likwang; Yu, Chong-Jen; Perng, Diahn-Warng; Cheng, Shih-Lung; Hsu, Jeng-Yuan; Hsu, Wu-Huei; Tsai, Ying-Huang; Hsiue, Tzuen-Ren; Lin, Meng-Chih; Lin, Hen-I; Chang, Yeun-Chung; Yang, Ueng-Cheng; Lin, Cing-Syong; Wei, Yu-Feng; Chong, Inn-Wen; Chen, Chung-Yu
Source
BMC Infectious Diseases. September 25, 2020, Vol. 20 Issue 1
Subject
Language
English
ISSN
1471-2334
Abstract
Author(s): Tsan-Ming Huang[sup.1], Kuan-Chih Kuo[sup.2], Ya-Hui Wang[sup.3], Cheng-Yi Wang[sup.1], Chih-Cheng Lai[sup.4], Hao-Chien Wang[sup.5], Likwang Chen[sup.6], Chong-Jen Yu[sup.5], Chong-Jen Yu, Hao-Chien Wang, Diahn-Warng Perng, Shih-Lung Cheng, Jeng-Yuan Hsu, Wu-Huei Hsu, Jeng-Yuan [...]
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. Keywords: Fluticasone/salmeterol, Budesonide/formoterol, COPD, Tuberculosis
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. Keywords: Fluticasone/salmeterol, Budesonide/formoterol, COPD, Tuberculosis