TY - JOUR
T1 - Withdrawal of inhaled corticosteroids in patients with COPD – A prospective observational study
AU - Nielsen, Anne Orholm
AU - Hilberg, Ole
AU - Jensen, Jens Ulrik Stæhr
AU - Kristensen, Steffen Helmer
AU - Frølund, Jannie Christina
AU - Langkilde, Pernille Kølholt
AU - Løkke, Anders
N1 - The abstract of this paper was presented as an E-poster at the European Respiratory Society International Congress 2020. The poster’ s abstract was published in “Poster Abstracts” in European Respiratory Journal 2020; 56: Suppl. 64, 2420, DOI: 10.1 183/13993003.congress-2020.2420.
PY - 2021/3/26
Y1 - 2021/3/26
N2 - Background: Inhaled corticosteroids (ICS) are widely used in the treatment of chronic obstructive pulmonary disease (COPD), but recent studies have raised doubts whether all COPD patients will benefit from ICS. This study evaluates in a real-life setting the effects of ICS withdrawal in patients with COPD. Methods: The study was a prospective intervention study following patients with COPD for 6 months after abrupt withdrawal of ICS. FEV1 (L), blood eosinophilic count (x10E9/L) and number of exacerbations were measured at baseline, 1, 3 and 6 months after ICS withdrawal. Results: Ninety-six patients (56 females (57.4%), mean age 70 years (51–94 years)) with COPD were included in the study. Eleven patients were excluded during the study period (7 patients died, 4 patients withdrew their consent during the study period). During the 6 months, 51 patients (60%) had resumed treatment with ICS, of whom 34 patients (68%) experienced an exacerbation during follow-up. No significant decline in FEV1 was seen in this group between baseline and after 6 months (ΔFEV1 0.07 L, p = 0.09). In the remaining 34 patients (40%) without ICS after 6 months of follow-up, 15 patients (44.1%) experienced an exacerbation. No significant decline was seen in FEV1 at baseline and after 6 months (ΔFEV1 0.04 L, p = 0.28). There were no statistically significant differences between the two groups in age (70.5 vs 69.6 years, p = 0.53), nor between FEV1 at baseline (0.96 L vs 1.00 L, p = 0.63) or eosinophilic count (0.25 x10E9/L vs 0.17 x10E9/L, p = 0.07). Conclusion: Abrupt withdrawal of ICS was possible in some patients. However, more than half of the patients resumed ICS during follow-up. Based on results from our study we were not able to foresee – from neither history of exacerbations nor eosinophilic count – whom will be able to manage without ICS and who will resume treatment with ICS.
AB - Background: Inhaled corticosteroids (ICS) are widely used in the treatment of chronic obstructive pulmonary disease (COPD), but recent studies have raised doubts whether all COPD patients will benefit from ICS. This study evaluates in a real-life setting the effects of ICS withdrawal in patients with COPD. Methods: The study was a prospective intervention study following patients with COPD for 6 months after abrupt withdrawal of ICS. FEV1 (L), blood eosinophilic count (x10E9/L) and number of exacerbations were measured at baseline, 1, 3 and 6 months after ICS withdrawal. Results: Ninety-six patients (56 females (57.4%), mean age 70 years (51–94 years)) with COPD were included in the study. Eleven patients were excluded during the study period (7 patients died, 4 patients withdrew their consent during the study period). During the 6 months, 51 patients (60%) had resumed treatment with ICS, of whom 34 patients (68%) experienced an exacerbation during follow-up. No significant decline in FEV1 was seen in this group between baseline and after 6 months (ΔFEV1 0.07 L, p = 0.09). In the remaining 34 patients (40%) without ICS after 6 months of follow-up, 15 patients (44.1%) experienced an exacerbation. No significant decline was seen in FEV1 at baseline and after 6 months (ΔFEV1 0.04 L, p = 0.28). There were no statistically significant differences between the two groups in age (70.5 vs 69.6 years, p = 0.53), nor between FEV1 at baseline (0.96 L vs 1.00 L, p = 0.63) or eosinophilic count (0.25 x10E9/L vs 0.17 x10E9/L, p = 0.07). Conclusion: Abrupt withdrawal of ICS was possible in some patients. However, more than half of the patients resumed ICS during follow-up. Based on results from our study we were not able to foresee – from neither history of exacerbations nor eosinophilic count – whom will be able to manage without ICS and who will resume treatment with ICS.
KW - COPD
KW - Inhaled corticosteroids
KW - Real-life setting
KW - Withdrawal
UR - http://www.scopus.com/inward/record.url?scp=85103921924&partnerID=8YFLogxK
U2 - 10.2147/COPD.S294217
DO - 10.2147/COPD.S294217
M3 - Journal article
C2 - 33814904
AN - SCOPUS:85103921924
SN - 1176-9106
VL - 16
SP - 807
EP - 815
JO - International Journal of COPD
JF - International Journal of COPD
ER -