Researchers in Japan report inhaled corticosteroid use and pneumonia may not be linked, despite previous studies associating the two, according to research in the International Journal of COPD.

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Researchers retrospectively examined 639 patients with COPD in a facility in Japan from 2009 to 2013. According to the study, 51 patients developed pneumonia (7.98%). Among 252 ICS-treated COPD patients, 13 (5.16%) developed pneumonia, compared to 38 (9.82%) of the 387 patients not treated with ICS.

Mortality rates were 7.7% in ICS-treated patients compared to 10.5% in non-ICS patients.

In addition, the study reported a higher risk of pneumonia for COPD patients using fluticasone/salmeterol (Advair) compared to budesonide/formoterol (Symbicort).

“The use of ICS did not increase the risk of pneumonia or mortality due to pneumonia in Japanese patients with COPD and ICS can be safely used,” the researchers concluded, but urged greater research due to “apparent differences in lung diseases among races.”