Cigarette smoking and response to inhaled corticosteroids in COPD. Issue 1 (18th January 2018)

• Record Type: Journal Article
• Authors: Bhatt, Surya P.; Anderson, Julie A.; Brook, Robert D.; Calverley, Peter M.A.; Celli, Bartolome R.; Cowans, Nicholas J.; Crim, Courtney; Martinez, Fernando J.; Newby, David E.; Vestbo, Jørgen; Yates, Julie C.; Dransfield, Mark T.
• Is Part Of: European respiratory journal. Volume 51:Issue 1(2018)
• Publication Date: 2018-01-18
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01393-2017
• Languages: English
• ISSNs: 0903-1936

Abstract

Inhaled corticosteroids (ICS) and long-acting β-agonists (LABA) are frequently used in patients with chronic obstructive pulmonary disease (COPD). Combination treatment with ICS/LABA improves lung function and quality of life, and reduces exacerbation frequency compared to treatment with either ICS or LABA alone. Although it is presumed that continued cigarette smoking impairs acute responses to these medications in patients with COPD, there is little direct evidence to support this view. Studies of ICS use in asthma have shown less short-term improvement in lung function and reduced anti-inflammatory effects in active smokers compared to non-smokers [1, 2]. Although similar effects are plausible in COPD, they have not been definitively demonstrated. We hypothesised that former smokers with COPD would have greater short- and long-term changes in lung function, respiratory-related quality of life, and exacerbation risk, in response to ICS than continuing and intermittent smokers. Current smokers have a blunted FEV1 response and exacerbation reduction with inhaled corticosteroids http://ow.ly/PBIW30hcISK