TY - JOUR T1 - Patient-reported clinical control and peak-flow: Effects of 30 versus 6 month treatment with inhaled corticosteroids (ICS) with/without long-acting<sub>2</sub>-agonists (LABA) in moderately severe COPD JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p4614 AU - J.B. Snoeck-Stroband AU - T.S. Lapperre AU - M.M.E. Gosman AU - W.J.J. Assendelft AU - H.M. Boezen AU - N.H.T. ten Hacken AU - T. van der Molen AU - P.S. Hiemstra AU - D.S. Postma AU - P.J. Sterk AU - J.K. Sont Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p4614.abstract N2 - Rationale: Long-term ICS therapy can improve FEV1-decline in COPD [Celli AJRCCM 2008], whilst discontinuation worsens FEV1-decline [Lapperre Annals 2009]. Self-monitoring may strengthen adherence to chronic medications when immediate impact on symptom control can be demonstrated.Aim: To examine effects of 30 vs. 6 months ICS/LABA therapy on clinical control and PEF in COPD.Methods: 114 Patients (GLUCOLD study: 62±8 yr, 46±24 packyr, no steroids &gt;6 mo, postbr FEV1 63±9%pred, postbr FEV1/IVC 48±9%) were studied, comparing fluticasone propionate (FP) 30 and 6 mo (500 μg bid), FP/salmeterol (S) (50 μg bid) 30 mo and placebo (P). 2-Week diary cards with daily Clinical COPD Questionnaire (CCQ) and PEF were obtained every 3 months. A linear mixed effects model was used for analysis of highest CCQ scores and lowest PEF.Results: PEF-level was increased for FP/S vs. FP (37 ml, p=0.001) at 6 mo. Continuation of FP improved CCQ functional score over time (-0.14/yr, p=0.039) and ameliorated PEF (11 ml/yr, p=0.042) vs. P. Discontinuation of FP at 6 mo worsened total (0.11/yr, p=0.025) and symptom score (0.17/yr, p=0.012) and diminished PEF (-12 ml, p=0.032) vs. its continuation. Addition of S to FP increased total (0.12/yr, p=0.015) and functional score over time (0.16/yr, p=0.026) and reduced PEF (-12 ml/yr, p=0.03) vs. FP.Conclusion: Long-term ICS therapy improves functional performance and PEF, whilst discontinuation worsens total score, symptoms and PEF. Addition of S to FP increases PEF-level. ICS therapy may provide beneficial effects on patient-reported outcomes in moderately severe COPD. ER -