New data examines effect of inhaled corticosteroids (ICS) on survival in patients with COPD

November 06, 2002

SAN DIEGO (November 6, 2002) -- The findings of a retrospective database study examining the effect of inhaled corticosteroids (ICS) on survival in COPD patients1 were presented today at the American College of Chest Physicians CHEST 2002 Annual Conference in San Diego.

The investigators identified male and female patients, ages 40 and older, who were enrolled in the Lovelace and Kaiser Permanente-Georgia health plans during 1995 to 2000 and who had a diagnosis of COPD. In total, 1,685 patients were identified: the 'exposed groups' consisted of patients who had 90 days or more use of ICS (n= 786), ICS plus salmeterol (n=332) or salmeterol without ICS (n=170); the reference, or 'unexposed,' group (n=397) were patients who had not used ICS or a long-acting beta2-agonist but had been exposed to another respiratory drug for 90 days or more.

During the study period, 28 percent of patients in the unexposed group died compared to 14 percent of patients who had been exposed to ICS and/or salmeterol. In a statistical model that controlled for age, sex, comorbid conditions, COPD severity, and asthma status and severity, exposure to either ICS (Hazard Ratio [HR] 0.59, 95% Confidence Interval [CI]: 0.46, 0.78) or salmeterol (Hazard Ratio [HR] 0.55, 95% Confidence Interval [CI]: 0.34, 0.89) were associated with a decreased risk of death. In addition, exposure to ICS plus salmeterol also reduced the risk of death (HR 0.34, 95% CI: 0.21, 0.56). In a sensitivity analysis including only those COPD patients without a history of asthma (n=840), the reduction in risk of death associated with the use of ICS plus salmeterol remained significant (HR 0.35, 95% CI: 0.17, 0.71). Use of inhaled corticosteroids was associated with longer survival in COPD patients, independent of an asthma diagnosis, age, gender, or COPD severity.

According to the CDC, approximately 24 million Americans have evidence of impaired lung function consistent with a diagnosis of COPD, the fourth leading cause of death in the US. 2 In 2000, there were 119,052 deaths from COPD. 2

COPD is a multi-component disease that includes airway inflammation, bronchoconstriction and structural changes that result in airflow obstruction. These components contribute to complex changes in lung function, symptoms and exacerbations, which affect health status and ultimately survival.

No drug has been prospectively shown to reduce mortality in COPD. It is important to note that no inhaled corticosteroid alone, or combined with a long-acting bronchodilator, is currently approved for the treatment of COPD in the US.

Serevent DiskusÒ (salmeterol inhalation powder) should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrthymias, and hypertension, and in patients with convulsive disorders or thytotoxicosis. Some patients may experience an increase in blood pressure or heart rate. Salmeterol should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants.
-end-
Contact Robin Gaitens at 919-483-2839 for complete prescribing information for Serevent Diskus.

Sources

1. Mapel D, Roblin D, Hurley J, Davis KJ, Schreiner R, Roberts M, Frost F. Survival of COPD patients exposed to inhaled corticosteroids. Chest 2002;122(4 Suppl):74S.

2. "Chronic Obstructive Pulmonary Disease Surveillance - United States, 1971-2000," Morbidity and Mortality Weekly Report, vol. 51; No. SS-6; August 2, 2002.

Ogilvy Public Relations

Related Asthma Articles from Brightsurf:

Breastfeeding and risks of allergies and asthma
In an Acta Paediatrica study, exclusive breastfeeding for the first 3 months was linked with a lower risk of respiratory allergies and asthma when children reached 6 years of age.

Researchers make asthma breakthrough
Researchers from Trinity College Dublin have made a breakthrough that may eventually lead to improved therapeutic options for people living with asthma.

Physics vs. asthma
A research team from the MIPT Center for Molecular Mechanisms of Aging and Age-Related Diseases has collaborated with colleagues from the U.S., Canada, France, and Germany to determine the spatial structure of the CysLT1 receptor.

New knowledge on the development of asthma
Researchers at Karolinska Institutet in Sweden have studied which genes are expressed in overactive immune cells in mice with asthma-like inflammation of the airways.

Eating fish may help prevent asthma
A scientist from James Cook University in Australia says an innovative study has revealed new evidence that eating fish can help prevent asthma.

Academic performance of urban children with asthma worse than peers without asthma
A new study published in Annals of Allergy, Asthma and Immunology shows urban children with poorly controlled asthma, particularly those who are ethnic minorities, also suffer academically.

Asthma Controller Step Down Yardstick -- treatment guidance for when asthma improves
The focus for asthma treatment is often stepping up treatment, but clinicians need to know how to step down therapy when symptoms improve.

Asthma management tools improve asthma control and reduce hospital visits
A set of comprehensive asthma management tools helps decrease asthma-related visits to the emergency department, urgent care or hospital and improves patients' asthma control.

Asthma linked to infertility but not among women taking regular asthma preventers
Women with asthma who only use short-acting asthma relievers take longer to become pregnant than other women, according to research published in the European Respiratory Journal.

What are the best ways to diagnose and manage asthma?
A team of experts from The University of Texas Medical Branch at Galveston examined the current information available from many different sources on diagnosing and managing mild to moderate asthma in adults and summarized them.

Read More: Asthma News and Asthma Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.