dc.contributor
Institut Català de la Salut
dc.contributor
[Magnussen H] Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Center of Lung Research, Grosshansdorf, Germany. [Lucas S] Respiratory Efectiveness Group, Ely, UK. [Lapperre T] Department of Respiratory Medicine, Antwerp University Hospital, Edegem, Denmark. Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Wilrijk, UK. [Quint JK] Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Wilrijk, UK. [Dandurand RJ] CIUSSS de L’Ouest de L’Île de Montréal, Montreal Chest Institute, Meakins Christie Laboratories, Oscillometry Unit and Centre for Innovative Medicine, McGill University Health Centre and Research Institute, Montreal, QC, Canada. [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Magnussen, Helgo
dc.contributor.author
Lucas, Sarah
dc.contributor.author
Lapperre, Therese
dc.contributor.author
Quint, Jennifer K.
dc.contributor.author
Dandurand, Ronald J.
dc.contributor.author
Roche, Nicolas
dc.contributor.author
Miravitlles Fernández, Marc
dc.date.accessioned
2023-11-06T10:29:02Z
dc.date.available
2023-11-06T10:29:02Z
dc.date.issued
2021-05-27T10:01:26Z
dc.date.issued
2021-05-27T10:01:26Z
dc.date.issued
2021-01-21
dc.identifier
Magnussen H, Lucas S, Lapperre T, Quint JK, Dandurand RJ, Roche N, et al. Withdrawal of inhaled corticosteroids versus continuation of triple therapy in patients with COPD in real life: observational comparative effectiveness study. Respir Res. 2021 Jan 21;22:25.
dc.identifier
https://hdl.handle.net/11351/5986
dc.identifier
10.1186/s12931-021-01615-0
dc.identifier
000612880800001
dc.identifier.uri
https://hdl.handle.net/11351/5986
dc.description.abstract
MPOC; Eficàcia; Corticoides inhalats
dc.description.abstract
EPOC; Eficacia; Corticosteroides inhalados
dc.description.abstract
COPD; Effectiveness; Inhaled corticosteroids
dc.description.abstract
Background
Inhaled corticosteroids (ICS) are indicated for prevention of exacerbations in patients with COPD, but they are frequently overprescribed. ICS withdrawal has been recommended by international guidelines in order to prevent side effects in patients in whom ICS are not indicated.
Method
Observational comparative effectiveness study aimed to evaluate the effect of ICS withdrawal versus continuation of triple therapy (TT) in COPD patients in primary care. Data were obtained from the Optimum Patient Care Research Database (OPCRD) in the UK.
Results
A total of 1046 patients who withdrew ICS were matched 1:4 by time on TT to 4184 patients who continued with TT. Up to 76.1% of the total population had 0 or 1 exacerbation the previous year. After controlling for confounders, patients who discontinued ICS did not have an increased risk of moderate or severe exacerbations (adjusted HR: 1.04, 95% confidence interval (CI) 0.94–1.15; p = 0.441). However, rates of exacerbations managed in primary care (incidence rate ratio (IRR) 1.33, 95% CI 1.10–1.60; p = 0.003) or in hospital (IRR 1.72, 95% CI 1.03–2.86; p = 0.036) were higher in the cessation group. Unsuccessful ICS withdrawal was significantly and independently associated with more frequent courses of oral corticosteroids the previous year and with a blood eosinophil count ≥ 300 cells/μL.
Conclusions
In this primary care population of patients with COPD, composed mostly of infrequent exacerbators, discontinuation of ICS from TT was not associated with an increased risk of exacerbation; however, the subgroup of patients with more frequent courses of oral corticosteroids and high blood eosinophil counts should not be withdrawn from ICS.
dc.description.abstract
The study was funded by a Grant from Boehringer Ingelheim.
dc.format
application/pdf
dc.relation
Respiratory Research;22
dc.relation
https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-021-01615-0
dc.rights
Attribution 4.0 International
dc.rights
http://creativecommons.org/licenses/by/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Pulmons - Malalties obstructives - Tractament
dc.subject
Avaluació de resultats (Assistència sanitària)
dc.subject
DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
dc.subject
Other subheadings::Other subheadings::Other subheadings::/drug therapy
dc.subject
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome
dc.subject
ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica
dc.subject
Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
dc.title
Withdrawal of inhaled corticosteroids versus continuation of triple therapy in patients with COPD in real life: observational comparative effectiveness study
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
