Many patients with moderately severe or worse chronic obstructive pulmonary disease (COPD) are receiving an inhaled corticosteroid (ICS) in addition to a long-acting beta-agonist (LABA) and/or a long-acting muscarinic antagonist (LAMA). Because prolonged use of an ICS may carry a risk for adverse events, the question is raised of whether these agents provide benefit above that of the bronchodilators.
The primary outcome, time to first exacerbation, did not differ between the group that continued ICS therapy and the group from whom ICS was withdrawn. Among secondary outcomes, the trough FEV1 was an average of 38 mL higher (ie, better) in the ICS group than the placebo group; this difference was statistically significant, but not clinically meaningful. A dyspnea measurement, the modified Medical Research Council (mMRC) scale, did not differ between the treatment groups.
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