WISDOM
Withdrawal of Inhaled Steroids During Optimised Bronchodilator Management
Patient / Population Intervention / Exposure Comparison Outcome
In 2,485 patients with severe COPD on triple therapy, stepwise withdrawal of inhaled corticosteroids was non-inferior for time to moderate-or-severe exacerbation compared with continued ICS.
N
2,485
Design
Multicentre RCT
Endpoint
Time to first moderate or severe exacerbation
Relevance
2
ResultHR 1.06 (95% CI 0.94–1.19); FEV1 declined 38 mL more with withdrawal.
Magnussen H, et al. N Engl J Med. 2014;371(14):1285-1294. 10.1056/NEJMoa1407154
Discussion & critique
ICS can be withdrawn in many COPD patients on dual bronchodilator therapy; risk concentrates in eosinophilia ≥300/µL.