RT Journal Article
SR Electronic
T1 The impact of stepwise withdrawal of inhaled corticosteroids on lung function in COPD patients receiving dual bronchodilation: WISDOM study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2423
VO 44
IS Suppl 58
A1 Henrik Watz
A1 Peter Calverley
A1 Pascal Chanez
A1 Ronald Dahl
A1 Marc Decramer
A1 Bernd Disse
A1 Helen Finnigan
A1 Anne Kirsten
A1 Roberto Rodriguez-Roisin
A1 Kay Tetzlaff
A1 Lesley Towse
A1 Emiel Wouters
A1 Helgo Magnussen
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2423.abstract
AB Background: WISDOM (NCT00975195) demonstrated non-inferiority in exacerbation risk with ICS withdrawal versus ICS (ERS 2014). Here we report the change in lung function.Objective: To evaluate the effects of stepwise withdrawal of ICS in patients (pts) with GOLD 3–4 COPD and a history of exacerbation treated with LAMA+LABA.Methods: WISDOM was a 12-month, double-blind, parallel-group, active-controlled study where all pts received triple therapy (tiotropium 18 µg QD, salmeterol 50 µg BID and fluticasone 500 µg BID) for a 6-week run-in period. Pts were randomised 1:1 to continue triple therapy or stepwise withdrawal of ICS over 12 weeks (dose reduction every 6 weeks). Secondary end points included trough FEV1.Results: 2485 pts were treated (2049 male); mean age was 63.8 years and mean baseline FEV1 was 0.975 L (34.2% predicted). At Week 18, the adjusted mean decrease from baseline (Week 0) in trough FEV1 was 38 mL greater on complete ICS withdrawal than on ICS (p<0.0001), with similar results at Week 52.Conclusions: While exacerbation risk is comparable irrespective of concomitant ICS therapy in pts with GOLD 3–4 COPD receiving dual bronchodilation, there was a small but statistically significantly greater decrease in lung function with complete ICS withdrawal.Funding: Boehringer Ingelheim.