Background The potential association between the use of inhaled corticosteroids (ICS) and the risk of pneumonia among adults is disputed and paediatric-specific evidence is scarce. Aim To assess the potential association between ICS, use and the risk of hospitalisation for pneumonia among children (age 2–17 years) with asthma. Methods This was a cohort study based on nationwide data from routine clinical practice in Sweden (January 2007 to November 2021). From 425 965 children with confirmed asthma, episodes of new ICS use and no use were identified using records of dispensed drugs. We adjusted for potential confounders with propensity score overlap weighting and the risk of a hospitalisation with pneumonia as primary diagnosis was estimated. Multiple subgroup and sensitivity analyses were also performed. Results We identified 249 351 ICS (mean follow-up of 0.9 years) and 214 840 no-use (mean follow-up of 0.7 years) episodes. During follow-up, 369 and 181 events of hospitalisation for pneumonia were observed in the ICS and no-use episodes, respectively. The weighted incidence rates of hospitalisation for pneumonia was 14.5 per 10 000 patient-years for ICS use episodes and 14.6 for no-use episodes. The weighted HR for hospitalisation for pneumonia associated with ICS use was 1.06 (95% CI 0.88 to 1.28) and the absolute rate difference was −0.06 (95% CI −2.83 to 2.72) events per 10 000 patient-years, compared with no use. Conclusions In this nationwide cohort study, we found no evidence of an association between ICS use and the risk of hospitalisation for pneumonia among children with asthma, as compared with no use. Data may be obtained from a third party and are not publicly available. Raw data may be obtained following permission from the register holders.

中文翻译：

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哮喘儿童吸入皮质类固醇的使用与肺炎住院风险：一项全国性队列研究

背景 使用吸入皮质类固醇 (ICS) 与成人肺炎风险之间的潜在关联存在争议，且儿科特异性证据很少。目的 评估患有哮喘的儿童（2-17 岁）中 ICS、使用与肺炎住院风险之间的潜在关联。方法 这是一项基于瑞典常规临床实践全国数据（2007 年 1 月至 2021 年 11 月）的队列研究。通过配发药物记录，从 425 965 名确诊哮喘的儿童中确定了新使用 ICS 和未使用 ICS 的情况。我们调整了倾向评分重叠加权的潜在混杂因素以及估计初步诊断时因肺炎住院的风险。还进行了多个亚组和敏感性分析。结果 我们确定了 249 351 例 ICS（平均随访 0.9 年）和 214 840 例未使用（平均随访 0.7 年）事件。在随访期间，ICS 事件和未使用事件中分别观察到 369 起和 181 起肺炎住院事件。使用 ICS 时，肺炎住院的加权发生率为每 10 000 患者年 14.5 例，未使用时为 14.6 例。与未使用 ICS 相比，因使用 ICS 相关的肺炎住院的加权 HR 为 1.06（95% CI 0.88 至 1.28），绝对发生率差异为每 10 000 名患者年 -0.06（95% CI -2.83 至 2.72）个事件。结论 在这项全国性队列研究中，我们没有发现任何证据表明与不使用 ICS 相比，哮喘儿童使用 ICS 与肺炎住院风险之间存在关联。数据可能从第三方获得，并且不公开。原始数据可在获得登记持有人许可后获取。