Center of Clinical Pharmacology, Third Xiangya Hospital, Central South University, No 138, Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China.
Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China.
Lung. 2024 Oct;202(5):673-681. doi: 10.1007/s00408-024-00741-y. Epub 2024 Aug 27.
Inhaled corticosteroids (ICS) are effective in managing asthma and chronic obstructive pulmonary disease (COPD) but increase the risk of pneumonia. Benzodiazepines (BZD), commonly prescribed for comorbid psychiatric disorders in asthma or COPD patients, are also associated with pneumonia. This study investigates the risk of pneumonia associated with the concomitant use of ICS and BZD.
Data from the FDA Adverse Event Reporting System from Q4 2013 to Q3 2023 were extracted. Reports involving asthma or COPD patients were included. Disproportionality analysis and logistic regression analysis were performed to assess the risk of pneumonia associated with the combined use of ICS and BZD. Additive and multiplicative models were used to further confirm the results. Additionally, subgroup analyses were conducted based on gender, age, and disease type.
A total of 238,411 reports were included. The combined use of ICS and BZD was associated with a higher reporting of pneumonia (ROR: 2.41, 95% CI 2.25-2.58). Using additive and multiplicative methods, the results remained significant. The strongest risk signals were observed in specific drug combinations, such as mometasone with clonazepam, budesonide with temazepam, and mometasone with zopiclone. Subgroup analyses showed higher pneumonia risks in females, patients over 60 years old, and those with asthma.
Our findings identified a significantly elevated pneumonia risk with the combined use of ICS and BZD. These results highlighted the necessity for cautious co-prescription of ICS and BZD and suggested the need for more comprehensive clinical studies to assess this interaction.
吸入性皮质类固醇（ICS）在治疗哮喘和慢性阻塞性肺疾病（COPD）方面非常有效，但会增加肺炎的风险。苯二氮䓬类药物（BZD）常用于治疗哮喘或 COPD 患者的共病精神障碍，也与肺炎有关。本研究调查了 ICS 和 BZD 同时使用与肺炎相关的风险。
从 2013 年第四季度到 2023 年第三季度，从 FDA 不良事件报告系统中提取数据。纳入涉及哮喘或 COPD 患者的报告。进行了比例失衡分析和逻辑回归分析，以评估 ICS 和 BZD 联合使用与肺炎相关的风险。使用加性和乘法模型进一步证实了结果。此外，还根据性别、年龄和疾病类型进行了亚组分析。
共纳入 238411 份报告。ICS 和 BZD 联合使用与肺炎报告增加相关（ROR：2.41，95%CI 2.25-2.58）。使用加性和乘法方法，结果仍然显著。在特定的药物组合中观察到最强的风险信号，例如莫米松与氯硝西泮、布地奈德与替马西泮以及莫米松与唑吡坦。亚组分析显示女性、60 岁以上患者和哮喘患者的肺炎风险更高。
我们的研究结果表明，ICS 和 BZD 联合使用会显著增加肺炎风险。这些结果强调了谨慎联合处方 ICS 和 BZD 的必要性，并建议进行更全面的临床研究来评估这种相互作用。
