COPD Clinical Trial
Official title:
The Clinical Effect of Inhaled Corticosteroid Withdrawal in Chronic Obstructive Pulmonary Disease (COPD) Patients
According to the WISDOM study, withdraw of inhaled steroids has no effect on the acute
exacerbation of chronic obstructive pulmonary disease (COPD), but the lung function of
patients with COPD is significantly reclined. In the subgroup analysis of this study,
patients with COPD were found to have continued to use inhaled steroids in patients with
eosinophilic leukocytes greater than 400 cells/ul or whom has more than two episodes of
exacerbation per year. However, in SUNSET study, it was pointed out that withdraw of inhaled
steroids had no effect on lung function in patients with COPD, but it was also found that in
patients with COPD, eosinophilic leukocytes in the blood were greater than 300 cells/ul, have
a better therapeutic response in steroid inhalation. In addition, some studies have shown
that in patients with COPD, a decline in lung function after discontinuation of inhaled
steroids can make the patient's clinical symptoms worse and increase the risk of acute
exacerbations. However, in other comprehensive analytical studies, there are different
outcomes. There is no statistically significant difference in the risk of acute exacerbation
in patients with COPD after discontinuation of inhaled steroids.
In past studies, it was noted that inhaled steroids cause an increased risk of pneumonia in
patients with COPD. However, in these studies, the diagnosis of pneumonia was only from the
clinician's suspicion without clear symptom assessment, laboratory examination,
microbiological evidence or imaging assessment. Therefore, further research is needed to
assess whether patients are suitable for the reduction of inhaled steroids and the impact of
COPD in clinical treatment.
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