Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease

D. D. Sin, L. Wu, J. A. Anderson, N. R. Anthonisen, A. S. Buist, P. S. Burge, P. M. Calverley, J. E. Connett, B. Lindmark, R. A. Pauwels, D. S. Postma, J. B. Soriano, W. Szafranski, J. Vestbo

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown. Methods: A pooled analysis, based on intention to treat, of individual patient data from seven randomised trials (involving 5085 patients) was performed in which the effects of inhaled corticosteroids and placebo were compared over at least 12 months in patients with stable COPD. The end point was all-cause mortality. Results: Overall, 4% of the participants died during a mean follow up period of 26 months. Inhaled corticosteroids reduced all-cause mortality by about 25% relative to placebo. Stratification by individual trials and adjustments for age, sex, baseline post-bronchodilator percentage predicted forced expiratory volume in 1 second, smoking status, and body mass index did not materially change the results (adjusted hazard ratio (HR) 0.73; 95% confidence interval (CI) 0.55 to 0.96). Although there was considerable overlap between subgroups in terms of effect sizes, the beneficial effect was especially noticeable in women (adjusted HR 0.46; 95% CI 0.24 to 0.91) and former smokers (adjusted HR 0.60; 95% CI 0.39 to 0.93). Conclusions: Inhaled corticosteroids reduce all-cause mortality in COPD. Further studies are required to determine whether the survival benefits persist beyond 2-3 years.
OriginalsprogEngelsk
TidsskriftThorax
Vol/bind60
Udgave nummer12
Sider (fra-til)992-997
Antal sider6
ISSN0040-6376
DOI
StatusUdgivet - dec. 2005
Udgivet eksterntJa

Fingeraftryk

Chronic Obstructive Pulmonary Disease
Adrenal Cortex Hormones
Confidence Intervals
Placebos
Forced Expiratory Volume
Body Mass Index
Smoking

Emneord

  • Administration, Inhalation
  • administration & dosage: Adrenal Cortex Hormones
  • Cause of Death
  • Female
  • drug effects: Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • drug therapy: Pulmonary Disease, Chronic Obstructive
  • Randomized Controlled Trials
  • Research Support, Non-U.S. Gov't
  • Survival Analysis

Citer dette

Sin, D. D., Wu, L., Anderson, J. A., Anthonisen, N. R., Buist, A. S., Burge, P. S., ... Vestbo, J. (2005). Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease. Thorax, 60(12), 992-997. https://doi.org/10.1136/thx.2005.045385
Sin, D. D. ; Wu, L. ; Anderson, J. A. ; Anthonisen, N. R. ; Buist, A. S. ; Burge, P. S. ; Calverley, P. M. ; Connett, J. E. ; Lindmark, B. ; Pauwels, R. A. ; Postma, D. S. ; Soriano, J. B. ; Szafranski, W. ; Vestbo, J. / Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease. I: Thorax. 2005 ; Bind 60, Nr. 12. s. 992-997.
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title = "Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease",
abstract = "Background: Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown. Methods: A pooled analysis, based on intention to treat, of individual patient data from seven randomised trials (involving 5085 patients) was performed in which the effects of inhaled corticosteroids and placebo were compared over at least 12 months in patients with stable COPD. The end point was all-cause mortality. Results: Overall, 4{\%} of the participants died during a mean follow up period of 26 months. Inhaled corticosteroids reduced all-cause mortality by about 25{\%} relative to placebo. Stratification by individual trials and adjustments for age, sex, baseline post-bronchodilator percentage predicted forced expiratory volume in 1 second, smoking status, and body mass index did not materially change the results (adjusted hazard ratio (HR) 0.73; 95{\%} confidence interval (CI) 0.55 to 0.96). Although there was considerable overlap between subgroups in terms of effect sizes, the beneficial effect was especially noticeable in women (adjusted HR 0.46; 95{\%} CI 0.24 to 0.91) and former smokers (adjusted HR 0.60; 95{\%} CI 0.39 to 0.93). Conclusions: Inhaled corticosteroids reduce all-cause mortality in COPD. Further studies are required to determine whether the survival benefits persist beyond 2-3 years.",
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author = "Sin, {D. D.} and L. Wu and Anderson, {J. A.} and Anthonisen, {N. R.} and Buist, {A. S.} and Burge, {P. S.} and Calverley, {P. M.} and Connett, {J. E.} and B. Lindmark and Pauwels, {R. A.} and Postma, {D. S.} and Soriano, {J. B.} and W. Szafranski and J. Vestbo",
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Sin, DD, Wu, L, Anderson, JA, Anthonisen, NR, Buist, AS, Burge, PS, Calverley, PM, Connett, JE, Lindmark, B, Pauwels, RA, Postma, DS, Soriano, JB, Szafranski, W & Vestbo, J 2005, 'Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease', Thorax, bind 60, nr. 12, s. 992-997. https://doi.org/10.1136/thx.2005.045385

Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease. / Sin, D. D.; Wu, L.; Anderson, J. A.; Anthonisen, N. R.; Buist, A. S.; Burge, P. S.; Calverley, P. M.; Connett, J. E.; Lindmark, B.; Pauwels, R. A.; Postma, D. S.; Soriano, J. B.; Szafranski, W.; Vestbo, J.

I: Thorax, Bind 60, Nr. 12, 12.2005, s. 992-997.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease

AU - Sin, D. D.

AU - Wu, L.

AU - Anderson, J. A.

AU - Anthonisen, N. R.

AU - Buist, A. S.

AU - Burge, P. S.

AU - Calverley, P. M.

AU - Connett, J. E.

AU - Lindmark, B.

AU - Pauwels, R. A.

AU - Postma, D. S.

AU - Soriano, J. B.

AU - Szafranski, W.

AU - Vestbo, J.

PY - 2005/12

Y1 - 2005/12

N2 - Background: Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown. Methods: A pooled analysis, based on intention to treat, of individual patient data from seven randomised trials (involving 5085 patients) was performed in which the effects of inhaled corticosteroids and placebo were compared over at least 12 months in patients with stable COPD. The end point was all-cause mortality. Results: Overall, 4% of the participants died during a mean follow up period of 26 months. Inhaled corticosteroids reduced all-cause mortality by about 25% relative to placebo. Stratification by individual trials and adjustments for age, sex, baseline post-bronchodilator percentage predicted forced expiratory volume in 1 second, smoking status, and body mass index did not materially change the results (adjusted hazard ratio (HR) 0.73; 95% confidence interval (CI) 0.55 to 0.96). Although there was considerable overlap between subgroups in terms of effect sizes, the beneficial effect was especially noticeable in women (adjusted HR 0.46; 95% CI 0.24 to 0.91) and former smokers (adjusted HR 0.60; 95% CI 0.39 to 0.93). Conclusions: Inhaled corticosteroids reduce all-cause mortality in COPD. Further studies are required to determine whether the survival benefits persist beyond 2-3 years.

AB - Background: Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown. Methods: A pooled analysis, based on intention to treat, of individual patient data from seven randomised trials (involving 5085 patients) was performed in which the effects of inhaled corticosteroids and placebo were compared over at least 12 months in patients with stable COPD. The end point was all-cause mortality. Results: Overall, 4% of the participants died during a mean follow up period of 26 months. Inhaled corticosteroids reduced all-cause mortality by about 25% relative to placebo. Stratification by individual trials and adjustments for age, sex, baseline post-bronchodilator percentage predicted forced expiratory volume in 1 second, smoking status, and body mass index did not materially change the results (adjusted hazard ratio (HR) 0.73; 95% confidence interval (CI) 0.55 to 0.96). Although there was considerable overlap between subgroups in terms of effect sizes, the beneficial effect was especially noticeable in women (adjusted HR 0.46; 95% CI 0.24 to 0.91) and former smokers (adjusted HR 0.60; 95% CI 0.39 to 0.93). Conclusions: Inhaled corticosteroids reduce all-cause mortality in COPD. Further studies are required to determine whether the survival benefits persist beyond 2-3 years.

KW - Administration, Inhalation

KW - administration & dosage: Adrenal Cortex Hormones

KW - Cause of Death

KW - Female

KW - drug effects: Forced Expiratory Volume

KW - Humans

KW - Male

KW - Middle Aged

KW - drug therapy: Pulmonary Disease, Chronic Obstructive

KW - Randomized Controlled Trials

KW - Research Support, Non-U.S. Gov't

KW - Survival Analysis

U2 - 10.1136/thx.2005.045385

DO - 10.1136/thx.2005.045385

M3 - Journal article

VL - 60

SP - 992

EP - 997

JO - Thorax

JF - Thorax

SN - 0040-6376

IS - 12

ER -

Sin DD, Wu L, Anderson JA, Anthonisen NR, Buist AS, Burge PS et al. Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease. Thorax. 2005 dec;60(12):992-997. https://doi.org/10.1136/thx.2005.045385