Effects of Stopping Inhaled Corticosteroids in COPD Patients
Author Information
Author(s): Aklak B. Choudhury, Carolyn M. Dawson, Hazel E. Kilvington, Sandra Eldridge, Wai-Yee James, Jadwiga A. Wedzicha, Gene S. Feder, Chris J. Griffiths
Primary Institution: Centre for Health Sciences, Queen Mary's School of Medicine and Dentistry, Barts and The London
Hypothesis
Withdrawal of ICS in COPD patients would lead to an increased number of exacerbations, earlier onset of exacerbation, and a worsening of symptoms.
Conclusion
Withdrawal of long-term ICS in COPD patients in primary care increases the risk of exacerbation, shortens time to exacerbation, and causes symptom deterioration.
Supporting Evidence
- Patients taking placebo were more likely to return to their usual ICS following exacerbation.
- Exacerbation risk was significantly raised in the placebo group.
- Patients with mild COPD had increased exacerbation risk after withdrawal.
Takeaway
If people with COPD stop using their inhaled steroids, they might get worse and have more breathing problems.
Methodology
A randomised, double-blind, placebo-controlled trial involving 260 COPD patients from 31 practices who stopped their usual ICS and were allocated to either fluticasone or placebo.
Potential Biases
Potential bias due to differential cessation rates of study medication between groups.
Limitations
The study may not fully represent all COPD patients as it was conducted in primary care and had a specific inclusion criteria.
Participant Demographics
Mean age of participants was 67 years, with an average smoking history of 39 pack-years.
Statistical Information
P-Value
0.05
Confidence Interval
CI: 0.91–1.36
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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