Patients with moderate to severe chronic obstructive pulmonary disease (COPD) experienced significant decreases in lung function for up to 5 years after discontinuing long-term inhaled corticosteroid (ICS) treatment, according to a study by Dutch researchers published in CHEST. These patients also experienced steady worsening in airway hyperresponsiveness (AHR) and quality of life, according to investigators.

The current study, involving 114 patients with moderate to severe COPD, was a follow-up to a randomized trial in which participants were assigned to 30 months of treatment with inhaled fluticasone (500 µg bid), 30 months of fluticasone plus salmeterol (500/50 µg bid), or placebo.

Postbronchodilator FEV1 (forced expiratory volume in 1 second), AHR, and quality of life were assessed at baseline, at 30 months, and annually during the 5 years of follow up. Only about half the patients (58) completed the study.

Postbronchodilator FEV1 (forced expiratory volume in 1 second), AHR, and quality of life were assessed at baseline, at 30 months, and annually during the 5 years of follow up. Only about half the patients (58) completed the study.

Patients who used ICS during the treatment phase, but discontinued or used ICS intermittently during the 5 years of follow-up, showed significant annual declines in FEV1. For the fluticasone group the decline was -73mL/year (95% CI minus 119-minus 26; P=0.002). For the fluticasone plus salmeterol group the decline was -68 mL/year (95% CI minus 112-minus 25; P=0.002).