In the study of 152,412 asthma patients (of whom 1928 had a pneumonia event during follow-up), current use of inhaled corticosteroids was associated with an 83% increased risk of being hospitalized for pneumonia. This risk was greatest with higher doses, and dispensing of 500 µg or more of fluticasone-equivalent per day was associated with a 96% increase. Increased risks were seen with both budesonide (167% increase in risk) and fluticasone (93% increase in risk).
"While the increase in risk of pneumonia with the use of inhaled corticosteroids is well recognized in chronic obstructive pulmonary disease (COPD), in asthma patients the evidence has been equivocal. Our study suggests the risk may be present in asthma, although pneumonia in patients with asthma remains unusual and inhaled corticosteroids remain the best therapy available," said Dr. Pierre Ernst, senior author of the British Journal of Clinical Pharmacology study.
Article: Pneumonia Risk in Asthma Patients using Inhaled Corticosteroids: A Quasi-Cohort Study, Christina J. Qian, Janie Coulombe, Samy Suissa, Pierre Ernst, British Journal of Clinical Pharmacology, doi: 10.1111/bcp.13295, published online 28 March 2017.