• Adamantia Liapikou, Michael Toumbis, and Antoni Torres.
• Sotiria Hospital, 6th Respiratory Department , Mesogion 152, 11527, Athens , Greece +30 21 0776 3458 ; mliapikou@yahoo.com.
• Expert Opin Drug Saf. 2015 Aug 1; 14 (8): 1237-47.

IntroductionInhaled corticosteroids (ICS) are known to increase the risk of pneumonia in patients with chronic obstructive pulmonary disease. To estimate the association between ICS and pneumonia among users of ICS relative to non-ICS users and to examine whether this risk is dose related, class related and what's its association with the pneumonia-mortality or overall mortality.Areas CoveredThrough a comprehensive literature search of MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials.gov from inception to February 2015, we identified randomized controlled trials of ICS therapy lasting at least 6 months. We conducted meta-analyses to generate summary estimates comparing ICS with non-ICS treatment on the risk of pneumonia.Expert OpinionICS alone or in combination with long-acting β-agonists are associated with an increased risk of pneumonia but have no effect on pneumonia related mortality. It is important to identify those patients to benefit the most from ICS, as those with frequent exacerbations, a severe airway obstruction, a positive bronchodilator test or a sputum eosinophilia despite treatment.

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