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Advair, Symbicort Up Pneumonia Risks for COPD Sufferers

Feb 11, 2009 | Parker Waichman Alonso LLP

Advair, Symbicort and other inhaled corticosteroids may increase the risk of pneumonia in patients with chronic obstructive pulmonary disease (COPD) by as much as 70%, according to a news study.   The study, conducted by researchers at Wake Forest University Baptist Medical Center, was published in the Feb. 9 issue of the Archives of Internal Medicine.

Advair, and Symbicort are known as long-acting beta-agonists (LABA), a class of drugs used to treat asthma.  Both Advair and Symbicort use a LABA with an inhaled steroid.  Other LABAs, such as Serevent and Foradil, do not contain a steroid.

While Advair, made by GlaxoSmithKline, is approved to treat COPD, Symbicort has not been approved for such use.  But the maker of Symbicort, AstraZeneca,  is seeking such approval.  No stand-alone corticosteroid has been approved to treat COPD.

COPD , the fourth-leading cause of death in the United States, is a progressive, destructive disease of the lungs.  Symptoms include restricted breathing, secretion of mucus, oxidative stress and airway inflammation.

For this study, the research team reviewed the findings of 18 clinical trials that included a total of 16,996 people. The researchers looked for cases of pneumonia among people who were using inhaled corticosteroids for at least 24 weeks. They compared them with people who had used a placebo.  They also compared those who had used a combination of inhaled corticosteroids and LABA's such as Advair and Symbicort,  with those who had used only an LABA.

Those taking a corticosteroids, either alone or with an LABA, increased their risk of developing pneumonia by 60 to 70%.  That means that about one in every 47 people with COPD who uses a corticosteroid inhaler for a year is likely to develop pneumonia.

"Our robust meta-analysis clarifies that the risk of pneumonia reported as a serious adverse event, can be specifically attributed to the long-term use of the inhaled steroid component," the researchers wrote.

The study authors recommended that people should discuss the risks and benefits of using inhaled corticosteroids with their doctors.  Unfortunately, there are few alternatives available for people with COPD.