Systematic review of inhaled corticosteroid withdrawal effects in chronic obstructive pulmonary disease, and comparison with two "real-life" studies

Journal of Thoracic Disease
Wenjing YeFengfeng Han

Abstract

Chronic obstructive pulmonary disease (COPD) is common and preventable. The long-term safety of inhaled corticosteroid (ICS) use in COPD is still unclear and requires further investigation. This systematic review aimed to determine the effect of withdrawal of ICS use in COPD by examining randomized controlled trials (RCTs) and comparing their findings with those of "real-life" studies. Two independent reviewers searched for RCTs in the PubMed, EMBASE, and Cochrane databases and in CINAHL. Searches were conducted by using controlled vocabulary and free-text aliases for corticosteroids, COPD, and RCTs in each database. Data extraction was also conducted by the two reviewers. The main outcomes were exacerbations, lung function, health-related quality of life, symptoms, and exercise capacity. To assess the effect of ICS withdrawal more comprehensively, we also searched for "real-life" studies, and explored the reasons for different results among different trials. We located five RCTs, which met the inclusion criteria, and two "real-life" studies. Due to definitional and other discrepancies among trials, we could not perform a meta-analysis. In the RCTs, exacerbation was reported as an outcome in four out of five RCTs. Only one stud...Continue Reading

Citations

Sep 5, 2020·Expert Review of Clinical Pharmacology·Paola RoglianiLuigino Calzetta
Aug 2, 2020·NPJ Primary Care Respiratory Medicine·James N ColeSally A Hull
Nov 19, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·Robert A WiseRichard E K Russell

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