Withdrawal of Inhaled Glucocorticoids Influence on Exacerbation of COPD

Author: Rūta Mazetytė.Title: Withdrawal of Inhaled Glucocorticoids Influence on Exacerbation of COPD. The aim of the study: to determine spirometry measurements, frequency of COPD exacerbations and pneumonias of patients with severe and very severe COPD in glucocorticoid-withdrawal group and glucocorticoid-continuation group. Objectives: 1.To assess and compare spirometry measurements (FEV1, FVC) of patients treated in LSMU KK 2015 – 2016 years and with severe and very severe COPD between the glucocorticoid-withdrawal group and glucocorticoid-continuation group. 2. To assess and compare spirometry measurements‘ changes (FEV1, FVC) of patients treated in LSMU KK 2015 – 2016 years and with severe and very severe COPD between the glucocorticoid-withdrawal group and glucocorticoid-continuation group. 3. To assess and compare COPD exacerbation frequency of patients treated in LSMU KK 2015 – 2016 years and with severe and very severe COPD between the glucocorticoid-withdrawal group and glucocorticoid-continuation group. 4. To assess and compare pneumonia frequency of patients treated in LSMU KK 2015 2016 years and with severe and very severe COPD between the glucocorticoid-withdrawal group and glucocorticoid-continuation group. Methods and participants: in this retrospective study 89 patients with severe and very severe COPD treated in Lithuania University of Health Sciences (LUHS) Kaunas Clinics 2015-2016 years were analysed. The patients were divided into two groups: glucocorticoid-withdrawal group and glucocorticoid-continuation group. Following data from medical records was collected: characteristics, FEV1, FVC, COPD exacerbations and pneumonias per two years. Results: average FEV1 and FVC mean were no significantly different between the glucocorticoid-withdrawal group and glucocorticoid-continuation group (p≥0,05). COPD exacerbations were not significantly different between the glucocorticoid-withdrawal group and glucocorticoid-continuation group (p=0,13). The percentage of patients with exacerbations was similar in two groups (p=0,18). Pneumonias rate were significantly higher in the glucocorticoid-continuation group than in the glucocorticoid-withdrawal group (p=0,04). The percentage of patients who had pneumonia was similar in two groups (p=0,1). Conclusions: 1. In our retrospective study there was no difference of spirometry measurements (FEV1, FVC) between the glucocorticoid-withdrawal group and glucocorticoid-continuation group of patients treated in LSMU KK 2015 – 2016 years and with severe and very severe COPD. 2. In our retrospective study there was no difference of spirometry measurements changes (FEV1, FVC) between the glucocorticoid-withdrawal group and glucocorticoid-continuation group of patients treated in LSMU KK 2015 – 2016 years and with severe and very severe COPD. 3. In our retrospective study there was no difference of COPD exacerbation frequency between the glucocorticoid-withdrawal group and glucocorticoid-continuation group of patients treated in LSMU KK 2015 – 2016 years and with severe and very severe COPD. 4. In our retrospective study there was greater pneumonia frequency in glucocorticoid-continuation group of patients treated in LSMU KK 2015 – 2016 years and with severe and very severe COPD