WISDOM
Withdrawal of Inhaled Steroids During Optimised Bronchodilator Management
Paciente / Población Intervención / Exposición Comparación Desenlace
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
2485
Diseño
Multicentre RCT
Desenlace
Time to first moderate or severe exacerbation
Relevancia
2
ResultadoHR 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
Discusión y crítica
ICS can be withdrawn in many COPD patients on dual bronchodilator therapy; risk concentrates in eosinophilia ≥300/µL.