Pneumologie 2019; 73(S 01)
DOI: 10.1055/s-0039-1678011
Posterbegehung (P01) – Sektion Klinische Pneumologie
COPD im Wandel
Georg Thieme Verlag KG Stuttgart · New York

ICS withdrawal and exacerbation risk by GOLD 2017 Report: post hoc analysis of the WISDOM trial

H Watz
1   Pulmonary Research Institute at Lungclinic Grosshansdorf, Airway Research Center Northorf
,
H Magnussen
1   Pulmonary Research Institute at Lungclinic Grosshansdorf, Airway Research Center Northorf
,
R Rodriguez-Roisin
2   Universitat de Barcelona, Hospital Clinic Idibaps-Ciberes
,
K Tetzlaff
3   Ta Respiratory/Biosimilars, Boehringer Ingelheim International GmbH
,
M Hänsel
3   Ta Respiratory/Biosimilars, Boehringer Ingelheim International GmbH
,
A Müller
4   Biostatistics and Data Sciences Europe, Boehringer Ingelheim Pharma GmbH & Co. Kg
,
C Vogelmeier
5   Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg
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Publikationsdatum:
19. Februar 2019 (online)

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Introduction The 2017 GOLD[*] A – D grouping scheme is solely based on exacerbation history and symptoms, and no longer considers lung function.

Aim To examine the effect of ICS withdrawal in the WISDOM trial within the new GOLD 2017 groups A – D.

Methods In WISDOM, a 12-month, double-blind, parallel-group study, patients with COPD who had ≥ 1 exacerbation in the preceding 12 months and FEV1 < 50% predicted (GOLD 2013 C/D) received tiotropium, salmeterol and fluticasone propionate for 6 weeks, before randomisation to continue all three treatments or to stepwise withdrawal of fluticasone propionate. This is a post hoc analysis of the study by GOLD 2017 stage.

Results The proportion of the total population of patients experiencing exacerbations was lowest in the GOLD A group (35.8%) and highest in the GOLD D group (51.7%). There was no significant difference in exacerbations between ICS and ICS withdrawal in any group (Figure).

Conclusion The GOLD 2017 classification was a good predictor of exacerbation in WISDOM, with far fewer exacerbations in the GOLD A and B groups than in the C and D groups. Consistent with GOLD 2017 treatment recommendations and with the conclusions of the WISDOM trial, there was no significant increased risk of exacerbation with ICS withdrawal versus continuing ICS in any group.