Stopping inhaled glucocorticoids in patients with chronic obstructive pulmonary disease (COPD) who were using bronchodilators has little effect on symptoms, and there is no wisdom in continuing treatment, say researchers presenting the trial results at ERS International Congress 2014. The work was published simultaneously in the New England Journal of Medicine.
The double-blind study, known as the Withdrawal of Inhaled Steroids during Optimized Bronchodilator Management (WISDOM), includes more than 2400 patients receiving triple therapy combination of tiotropium (18 ?g once daily), salmeterol (50 ?g twice daily), and the inhaled glucocorticoid fluticasone propionate (500 ?g twice daily). The study included a 6-week run-in period with all 3 medications, after which patients were randomly assigned to continue triple therapy or step down fluticasone in 3 stages over 12 weeks.
Current recommendations for patients with severe COPD and frequent exacerbations call for combination inhaled glucocorticoids and long-acting bronchodilators, but newer drugs have prompted some to question that recommendation.
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