Chest
Original Research: COPDA Pooled Analysis of FEV1Decline in COPD Patients Randomized to Inhaled Corticosteroids or Placebo
Section snippets
Materials and Methods
The methods of the Inhaled Steroids Effect Evaluation in COPD study13have been reported. Briefly, we pooled data from all seven RCTs in which stable patients with COPD were randomly assigned to receive ICSs or placebo for at least 12 months. These trials included the Lung Health Study (LHS)-2,14the Copenhagen City Lung Study (CCLS),15Inhaled Steroids in Obstructive Lung Disease in Europe (ISOLDE),16ERS Study on COPD (EUROSCOP),17the Trial of Inhaled Steroids and Long Acting β2-Agonists,18and
Demographic and Clinical Characteristics
There were 3,911 COPD participants randomized to receive ICSs or placebo who had three of more measurements of FEV1. Of these, 29.2% were women(Table 1). Within all COPD participants analyzed in this pooled analysis, men were older, more frequently obese, and more likely to be current smokers than were women (p < 0.05) [Table 2]. Regarding COPD severity measured by FEV1, men had on average a higher FEV1in absolute terms, but a lower FEV1in terms of percent predicted than women (p < 0.05).
Treatment Effect (ICS vs Placebo in FEV1Decline Data)
In the
Discussion
The most important finding of the present study, which was conducted with primary individual-based data and was adjusted by major demographic and clinical characteristics, was that ICS therapy in COPD patients did not affect the rate of decline in FEV1among those who completed these randomized clinical trials. ICS therapy only produced significant but small improvements in FEV1over the first 6 months of therapy, an effect that was most pronounced in female ex-smokers. Beyond this time frame,
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Pharmacology Considerations in Women in Lung Disease and Critical Care
2021, Clinics in Chest MedicineCitation Excerpt :Increasing evidence for sex-related differences in chronic obstructive pulmonary disease (COPD) risk, progression, and outcomes has recently been noted, suggesting a need to assess the impact of COPD interventions in male and female patients separately.37 Differences have also been demonstrated in women compared with men in short-term responses to bronchodilators and inhaled corticosteroid therapy.38,39 Citing sex differences suggesting that both conjugative metabolism and renal tubular secretion of drugs may be lower in women than in men, Mohamed and colleagues40 investigated albuterol PK differences across sex and race.
Chronic obstructive pulmonary disease in Women. Is it Different?
2017, Archivos de BronconeumologiaStepping down therapy in COPD
2014, New England Journal of MedicineThe Importance of Early Chronic Obstructive Pulmonary Disease: A Lecture from 2022 Asian Pacific Society of Respirology
2023, Tuberculosis and Respiratory Diseases
Interdisciplinary Capacity Enhancement: Bridging Excellence in Respiratory Disease and Gender Studies (ICEBERGS), which is supported by funding from Canadian Institutes of Health Research (IGH/ICRH), the Canadian Lung Association, and the Heart and Stroke Foundation of Canada (http://www.icebergs.ubc.ca).
Dr. Soriano was an employee of GlaxoSmithKline, a manufacturer of respiratory drugs, up to 2005. Dr. Sin has received honoraria for speaking engagements from AstraZeneca and GlaxoSmithKline, and has received consultancy fees and research funding from GlaxoSmithKline. Dr. Anderson is currently an employee of GlaxoSmithKline, a manufacturer of respiratory drugs. Dr. Anthonisen and Dr. Buist are members of a respiratory advisory board for GlaxoSmithKline. Dr. Calverley has received honoraria for speaking engagements and research funding from AstraZeneca and GlaxoSmithKline. Dr. Petersson is currently an employee of AstraZeneca, a manufacturer of respiratory drugs. Dr. Postma has received honoraria for speaking engagements and research funding from AstraZeneca and GlaxoSmithKline. Dr. Vestbo has received honoraria for speaking engagements and research funding from AstraZeneca and GlaxoSmithKline. Drs. Zhang, Camp, Burge, Connett, and Szafranski have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).