Inhaled Corticosteroids With/Without Long-Acting β-Agonists Reduce the Risk of Rehospitalization and Death in COPD Patients

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Abstract
Introduction: In patients with COPD who have recently been hospitalized for their disease, we examined whether treatment with inhaled corticosteroids without or with long-acting β-adrenoceptor agonists (β-agonists) reduced rehospitalization and mortality. Study design: Retrospective cohort analysis in the UK General Practice Research Database. Methods: We compared rehospitalization for a COPD-related medical condition or death within 1 year after first hospitalization, in 3636 COPD patients receiving prescriptions for inhaled corticosteroids or long-acting β-agonists compared with 627 reference patients with COPD who were prescribed short-acting bronchodilators only. Results: Rehospitalization within a year occurred in 13.2% of the reference COPD patients, 14.0% of users of long-acting β-agonists only, 12.3% of users of inhaled corticosteroids only, and 10.4% of users of inhaled corticosteroids and long-acting β-agonists. Death within a year occurred in 24.3% of the reference COPD patients, 17.3% of users of long-acting β-agonists only, 17.1% of users of inhaled corticosteroids only, and in 10.5% of users of inhaled corticosteroids and long-acting β-agonists. In multivariate analyses the risk of rehospitalization or death was reduced by 10% in users of long-acting β-agonists only (NS), by 16% in users of inhaled corticosteroids only, and by 41% in users of combined inhaled corticosteroids and long-acting β-agonists (both p < 0.05). Conclusion: Use of inhaled corticosteroids with/without long-acting β-agonists was associated with a reduction of rehospitalization or death in COPD patients.