Abstract
Background
Inhaled corticosteroids (ICS) are overused in patients with COPD despite recommendations since 2011 limiting their use to patients at high risk of exacerbation (GOLD Groups C and D).
Aim
To examine COPD medication use by patients before entering Phase III aclidinium studies.
Methods
Baseline data were pooled from the placebo and aclidinium arms of three, 6-month, placebo-controlled studies evaluating aclidinium mono- or combination therapy in patients with moderate-to-severe COPD, stratified to GOLD 2013 group using SGRQ total score (surrogate for CAT). Patients with asthma were excluded.
Results
Of 1787 patients with stable COPD (mean±SD: age 63.3±8.4 years, 63.0% male, 54.2±13.1% predicted FEV1), 56.3% were classified as low risk (Group A+B). The proportion of patients receiving ICS therapy (alone or combination) at baseline by GOLD group was assessed (Table); 41.3% and 43.5% of patients in Groups A and B, respectively, received ICS therapy (alone or combination). Overall, 93.8% patients had co-morbidities (range 91.3–98.1%), 5.7% prior history of pneumonia, 5.8 % diagnosed osteoporosis and 11.2% diabetes.
Conclusions
Prescribing patterns for patients with COPD did not reflect guidelines, with frequent ICS use in Groups A and B. Patients in all groups had co-morbidities potentially affected by ICS use; these need to be considered before prescribing ICSs to patients with COPD.
- © 2014 ERS
