Withdrawal of inhaled corticosteroids in individuals with COPD - a systematic review and comment on trial methodology
2011

Effects of Stopping Inhaled Corticosteroids in COPD Patients

Sample size: 615 publication 10 minutes Evidence: moderate

Author Information

Author(s): Nadeem Nighat J, Taylor Stephanie JC, Eldridge Sandra M

Primary Institution: Centre for Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London

Hypothesis

What are the effects of withdrawing inhaled corticosteroids in patients with COPD?

Conclusion

Withdrawing inhaled corticosteroids in COPD patients may lead to exacerbations occurring sooner, but the overall impact on the number of exacerbations is small.

Supporting Evidence

  • Three of the four trials included in the review had adequate methodological quality.
  • Patients who had inhaled corticosteroids withdrawn generally experienced worse outcomes, but the differences were mostly small and not statistically significant.
  • Meta-analysis indicated that patients who had medication withdrawn were 1.11 times more likely to have an exacerbation in the following year.

Takeaway

This study looked at what happens when people with COPD stop using their inhaled steroids. It found that stopping might make them have problems sooner, but not a lot more problems overall.

Methodology

The study systematically reviewed trials comparing patients withdrawn from inhaled corticosteroids with those who continued treatment, assessing outcomes like exacerbations and lung function.

Potential Biases

Potential biases were identified in trial methodologies, including randomization and blinding issues.

Limitations

The review did not include non-English studies and had limited data from the trials, restricting the meta-analysis to one outcome.

Participant Demographics

Participants included both male and female COPD patients aged 40 and above, with varying severity of the disease and duration of steroid use.

Statistical Information

P-Value

0.05

Confidence Interval

95% CI 0.84 to 1.46

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1465-9921-12-107

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication