New data examines step-wise withdrawal of inhaled corticosteroids in COPD
In patients with severe to very severe COPD and a history of exacerbation, the risk of moderate or severe exacerbations during 1 year of follow-up was non-inferior between those patients who continued on inhaled corticosteroids (ICS) and those who discontinued ICS therapy in a step-wise manner, as long as patients continued to receive maintenance treatment with long-acting bronchodilators (tiotropium and a long-acting beta agonist [LABA]), according to data presented at the European Respiratory Society (ERS) International Congress 2014 and also published in The New England Journal of Medicine.
Dr McBryan
In patients with severe to very severe COPD and a history of exacerbation, the risk of moderate or severe exacerbations during 1 year of follow-up was non-inferior between those patients who continued on inhaled corticosteroids (ICS) and those who discontinued ICS therapy in a step-wise manner, as long as patients continued to receive maintenance treatment with long-acting bronchodilators (tiotropium and a long-acting beta agonist [LABA]), according to data presented at the European Respiratory Society (ERS) International Congress 2014 and also published in The New England Journal of Medicine.
Results of the 12-month, double-blind, parallel-group, active-controlled WISDOM (Withdrawal of Inhaled Steroids During Optimised bronchodilator Management) trial evaluated step-wise withdrawal of 2,400 ICS in patients with severe to very severe COPD and a history of exacerbation. In the trial, patients received triple therapy consisting of tiotropium 18 μg once daily, salmeterol 50 μg twice daily (LABA) and fluticasone 500 μg twice daily (ICS) for a 6-week run-in period.
“These patients were then randomly assigned 1:1 to continue triple therapy or step-wise withdrawal of ICS over 12 weeks [dose reduction every 6 weeks]” according to Danny McBryan, MD, vice president, clinical development & medical affairs – respiratory, Boehringer Ingelheim. “The primary end point was time to first moderate or severe on-treatment exacerbation.”
The time by which 25% of patients experienced a first moderate or severe exacerbation was 110 days in the ICS-withdrawal group and 107 days in the ICS-continuation group. The percentage of patients with any adverse event was 70.8% for those who continued on ICS and 71.7% for those where ICS was withdrawn.
Approximately 15 million Americans have been told by a healthcare provider that they have COPD.
The study was sponsored by Boehringer Ingelheim.
Related
Risk scale for COPD could help with hospital admissions
Remote Care Advancement for Heart Failure, COPD and Diabetes Patients
February 24th 2021In this week's episode of Tuning In to the C-Suite podcast, MHE's Briana Contreras spoke with Dr. Rob Kowal, chief medical officer of the Cardiac Rhythm and Heart Failure division at Medtronic. The two discussed how remote monitoring and IoT is changing healthcare and how remote technology is also gaining a wide-spread adoption to monitor patients at home who have chronic conditions like heart failure, chronic obstructive pulmonary disease and diabetes.
Listen
FDA Approves Neffy 1 mg Nasal Spray for Pediatric Patients
March 6th 2025Neffy 1 mg is now approved by the FDA to treat pediatric patients who weigh 33 to 65 lbs. Neffy was first FDA-approved as a 2 mg dose in August 2024 for the emergency treatment of anaphylaxis in children and adults weighing at least 66 lbs.
Read More
