Fluticasone propionate, an important  inhaled corticosteroid (ICS) used for treating COPD, is associated with an increased risk of pneumonia compared to budesonide, another ICS medication, in patients.  

In a nationwide retrospective cohort study in South Korea, researchers at the Department of Internal Medicine, Yonsei University Wonju College of Medicine, analysed 47,473 subjects comprising 14,518 fluticasone propionate users and 14,518 budesonide users to reach the conclusion. 

The study found that 14 percent of fluticasone propionate users were more likely to develop pneumonia than budesonide users (10%). The incidence rate per 100,000 person-years was 2,914.77 for fluticasone propionate users and 2,102.90 for budesonide users. The hazard ratio (HR) of pneumonia in fluticasone propionate compared to budesonide was 1.34 (95% CI 1.26– 1.43, p< 0.0001). The study found that the risk of pneumonia for fluticasone propionate compared to budesonide increased with higher ICS cumulative doses. So it concluded that ICS types and doses need to be carefully considered during treatment in patients with COPD.