Withdrawal of inhaled corticosteroids can be safe in COPD patients at low risk of exacerbation: A real-life study on the appropriateness of treatment in moderate COPD patients (OPTIMO)

Andrea Rossi, Massimo Guerriero, Antonio Corrado, Giovanni Paolo Ligia, Andrea Mussoni, Francesca Savoia, Filippo De Padova, Rigoletta Vincenti, Francesco Stefanelli, Dino Sella, Carlo Pareo, Vincenzo Bellia, Pietro Pirina, Stefano Baglioni, Francesco Costa, Andrea Vianello, Bruno Balbi, Gregorino Paone, Giuseppe Girbino, Francesca MeleCinzia Lastoria, Tommaso Benedetti, Piero Candoli, Brunilda Marku, Giorgio Piperno, Mario Del Donno, Erika Zanardi, Franco Pasqua, Marco Dottorini, Gerardo Ricchiuto, Giorgio De Bernardi, Mauro Carone, Salvatore Cardellicchio, Giulio Donazzan, Fulvio Benassi, Claudio Zamprogna, Antonio Foresi, Raffaela Giacobbe, Gabriele Ferretti, Fausto De Michele, Federico Reccardini, Michele Chiericozzi, Venerino Poletti, Sonia Gile, Emilio Melica, Guido Roggi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: It has been suggested that withdrawal of inhaled corticosteroids (ICS) in COPD patients on maintenance treatment results in deterioration of symptoms, lung function and exacerbations. The aim of this real-life, prospective, multicentric study was to investigate whether withdrawal of ICS in COPD patients at low risk of exacerbation is linked to a deterioration in lung function and symptoms and to a higher frequency of exacerbations.Methods: 914 COPD patients, on maintenance therapy with bronchodilators and ICS, FEV1>50% predicted, and <2 exacerbations/year were recruited. Upon decision of the primary physicians, 59% of patients continued their ICS treatment whereas in 41% of patients ICS were withdrawn and regular therapy was continued with long-acting bronchodilators mostly (91% of patients). FEV1, CAT (COPD Assessment Test), and occurrence of exacerbations were measured at the beginning (T0) and at the end (T6) of the 6 months observational period.Results: 816 patients (89.3%) concluded the study. FEV1, CAT and exacerbations history were similar in the two groups (ICS and no ICS) at T0 and at T6. We did not observe any deterioration of lung function symptoms, and exacerbation rate between the two groups at T0 and T6.Conclusions: We conclude that the withdrawal of ICS, in COPD patients at low risk of exacerbation, can be safe provided that patients are left on maintenance treatment with long-acting bronchodilators.

Original languageEnglish
Article number77
JournalRespiratory Research
Volume15
Issue number1
DOIs
Publication statusPublished - Jul 8 2014

Keywords

  • Bronchodilators
  • COPD
  • Exacerbations
  • Inhaled corticosteroids

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)

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