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Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease.

D D Sin¹, L Wu, J A Anderson

¹James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St Paul's Hospital, 1081 Burrard Street, and Department of Medicine, University of British Columbia, Vancouver, BC, Canada, V6Z 1Y6. dsin@mrl.ubc.ca

|October 18, 2005

Summary

Inhaled corticosteroids significantly reduce all-cause mortality in patients with chronic obstructive pulmonary disease (COPD). This finding offers new hope for improving survival rates in COPD patients.

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Area of Science:

Pulmonary Medicine
Clinical Trials
Respiratory Health

Background:

Clinical studies indicate inhaled corticosteroids (ICS) alleviate exacerbations and enhance health status in COPD patients.
The impact of ICS on COPD patient mortality remains largely undetermined.

Purpose of the Study:

To investigate the effect of inhaled corticosteroids on all-cause mortality in patients diagnosed with stable chronic obstructive pulmonary disease (COPD).

Main Methods:

A pooled analysis of individual patient data from seven randomized controlled trials was conducted.
The analysis included 5085 patients with stable COPD, comparing inhaled corticosteroids to placebo over a minimum of 12 months.
All-cause mortality served as the primary endpoint.

Main Results:

Inhaled corticosteroids demonstrated a significant reduction in all-cause mortality, approximately 25% relative to placebo.
Adjusted analyses, controlling for various patient factors, confirmed the mortality benefit (adjusted HR 0.73; 95% CI 0.55 to 0.96).
A particularly pronounced survival benefit was observed in women and former smokers.

Conclusions:

Inhaled corticosteroids are effective in reducing all-cause mortality among individuals with COPD.
Further research is warranted to ascertain the long-term persistence of these survival benefits beyond 2-3 years.