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Risk of COPD Exacerbations After Withdrawal of ICS

In a large primary care population, there was no increased risk of moderate to severe chronic obstructive pulmonary disease (COPD) exacerbations among patients with eosinophilia who withdrew their use of inhaled corticosteroids (ICS). Researchers identified 48,157 individuals aged ≥40 years diagnosed with COPD in the Clinical Practice Research Datalink (CPRD) between January 1, 2005 - January 31, 2014. They found:

  • Withdrawal of ICS was not associated with an increased risk of moderate-to-sever exacerbations among individuals with absolute blood eosinophil counts ≥0.34 x 109 cells/L or relative counts ≥4.0%.
  • Similarly, withdrawal of ICS was not associated with an increase risk of severe exacerbations among those with absolute blood eosinophil ≥0.34 x 109 cells/L or relative blood eosinophil counts ≥4.0%.
  • No increased risk of all-cause mortality was observed among those who withdrew from ICS irrespective of elevated absolute or relative blood eosinophil counts.

Citation:

Oshagbemi OA, et al. Blood eosinophil counts, withdrawal of inhaled corticosteroids and risk of COPD exacerbations and mortality in the Clinical Practice Research Datalink (CPRD). [Published online ahead of print May 23, 2019]. COPD. doi: 10.1080/15412555.2019.1608172.