Imperial College London
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ProfessorJenniferQuint

Faculty of Medicine, School of Public Health

Professor of Respiratory Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 8821j.quint

 
 
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Location

 

.922Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Bloom:2020:10.2147/copd.s241568,
author = {Bloom, CI and Douglas, I and Usmani, OS and Quint, JK},
doi = {10.2147/copd.s241568},
journal = {The International Journal of Chronic Obstructive Pulmonary Disease},
pages = {701--710},
title = {Inhaled corticosteroid treatment regimens and health outcomes in a UK COPD population study},
url = {http://dx.doi.org/10.2147/copd.s241568},
volume = {15},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Inhaled corticosteroids (ICS) are a prevailing treatment option for COPD patients but recent guidelines have relegated their use predominantly to patients with frequent exacerbations. Yet large numbers of patients worldwide are currently treated with ICS-containing regimens. We wished to determine in routine clinical practice how common ICS withdrawal is and the differences in health outcomes between patients managed on ICS-containing and non-ICS containing regimens.Patients and Methods: COPD patients were identified from the UK primary care electronic healthcare records, between 2014 and 2018. Patients were grouped into three treatment regimens: long-acting beta-agonist (LABA) and inhaled corticosteroids (ICS), LABA and long-acting muscarinic antagonist (LAMA), and triple therapy (LABA, LAMA and ICS). Annual incidence of ICS withdrawal was measured. Multivariable logistic regression was used to identify patient factors associated with withdrawal. Multivariable Poisson regression was used to assess the association of exacerbations and hospitalised pneumonia between the ICS-containing regimens (LABA-ICS and triple therapy) and patients prescribed LABA-LAMA.Results: Of 117,046 patients, around three-quarters were prescribed ICS-containing inhalers but ICS withdrawal occurred annually in only approximately 2– 3% of patients. Exacerbations in the past year, but not a past history of pneumonia, were associated with ICS withdrawal. A total of  31,034 patients using three treatment regimens (LABA-ICS, LABA-LAMA or triple therapy) were assessed for their relative risk of exacerbations and pneumonia; the exacerbation risk was slightly lower in LABA-ICS users but the same in triple therapy users, as compared to LABA-LAMA users (LABA-ICS adjusted IRR=0.82 (95% CI 0.73– 0.93), triple adjusted IRR=0.99 (95% CI 0.88– 1.11)). There was no difference in the pneumonia risk (LABA-ICS adjusted IRR=0.96 (95% CI 0.71– 1.31), triple adjusted IRR=1.16 (
AU  - Bloom,CI
AU  - Douglas,I
AU  - Usmani,OS
AU  - Quint,JK
DO  - 10.2147/copd.s241568
EP  - 710
PY  - 2020///
SN  - 1176-9106
SP  - 701
TI  - Inhaled corticosteroid treatment regimens and health outcomes in a UK COPD population study
T2  - The International Journal of Chronic Obstructive Pulmonary Disease
UR  - http://dx.doi.org/10.2147/copd.s241568
UR  - http://hdl.handle.net/10044/1/78746
VL  - 15
ER  -
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