Risks of Halting Corticosteroids in COPD Patients

Dutch researchers have found that halting treatment with inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) is associated with a higher risk and more rapid onset of exacerbations as well as a significant deterioration in quality of life. Their findings were reported in the November 15, 2002, issue of the American Journal of Respiratory and Critical Care Medicine.

The study involved 244 COPD patients who received a high dose of ICS for four months. Patients were then randomized to either continue ICS treatment or to receive placebo for six months. In the ICS group of 123 patients, 58 (47%) developed at least one exacerbation compared with 69 (57%) in the group of 121 placebo patients. Also, 26 of the placebo patients experienced rapid recurrent exacerbations and had to be placed on ICS again. Among the original ICS patients, only six had this experience.

Patients in the placebo group also revealed a significant deterioration in their total score, symptoms, and activities on a respiratory questionnaire. The study was conducted by researchers at the departments of epidemiology, statistics, and pulmonary medicine at the University Medical Center (Nijmegen, The Netherlands), led by Dr. Paul van der Valk.




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American Journal of Respiratory and Critical Care Medicine