, Volume 65, Issue 11, pp 1165-1166
Date: 15 Jul 2009

Seretide withdrawal increases airway inflammation in moderate COPD patients

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Introduction

Inhaled corticosteroids (ICS) are widely used to treat patients with chronic obstructive pulmonary disease (COPD), either alone or in combination with a long-acting beta agonist (LABA) [1]. Clinical trials of the effects of these drugs in COPD usually allow patients to be recruited irrespective of their previous ICS and/or LABA use [2]. In the subset of patients who are using ICS/LABA treatments, these are withdrawn at the start of the run-in period prior to randomisation to ensure that all patients in the study are at a similar baseline point [3]. However, it is probable that the withdrawal of medication in some patients causes clinical deterioration, which may continue if they are assigned to the placebo arm of the study. This is not clinically justifiable in some patients with severe or very severe COPD [Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage III–IV) [1]. However, in stable moderate COPD patients (GOLD stage II), ICS / LABA withdrawal is like