Logo Logo
Switch Language to German

Lutter, Johanna I.; Jörres, Rudolf A. ORCID logoORCID: https://orcid.org/0000-0002-9782-1117; Trudzinski, Franziska C.; Alter, Peter; Kellerer, Christina; Watz, Henrik; Welte, Tobias; Bals, Robert; Kauffmann-Guerrero, Diego ORCID logoORCID: https://orcid.org/0000-0003-1471-3290; Behr, Jürgen ORCID logoORCID: https://orcid.org/0000-0002-9151-4829; Holle, Rolf; Vogelmeier, Claus F. and Kahnert, Kathrin ORCID logoORCID: https://orcid.org/0000-0001-9633-3368 (2021): Treatment of COPD Groups GOLD A and B with Inhaled Corticosteroids in the COSYCONET Cohort - Determinants and Consequences. In: International Journal of Chronic Obstructive Pulmonary Disease, Vol. 16: pp. 987-998

Full text not available from 'Open Access LMU'.


Background: In COPD patients of GOLD groups A and B, a high degree of treatment with inhaled corticosteroids (ICS) has been reported, which is regarded as overtreatment according to GOLD recommendations. We investigated which factors predict ICS use and which relationship it has to clinical and functional outcomes, or healthcare costs. Methods: We used pooled data from visits 1 and 3 of the COSYCONET cohort (n=2741, n=2053, interval 1.5 years) including patients categorized as GOLD grades 1-4 and GOLD group A or B at both visits (n=1080). Comparisons were performed using ANOVA, and regression analyses using propensity matching and inverse probability weighting to adjust for differences between ICS groups. These were defined as having ICS at both visits (always) vs no ICS at both visits (never). Measures were divided into predictors of ICS treatment and outcomes. Results: Among 1080 patients, 608 patients were eligible for ICS groups (n=297 never, n=311 always). Prior to matching, patients with ICS showed significantly (p<0.05 each) impaired lung function, symptoms and exacerbation history. After matching, the outcomes generic quality of life and CO diffusing capacity were increased in ICS patients (p<0.05 each). Moreover, costs for respiratory medication, but not total health care costs, were significantly elevated in the ICS group by 780(sic) per year. Conclusion: ICS therapy in COPD GOLD A/B patients can have small positive and negative effects on clinical outcomes and health care costs, indicating that the clinical evaluation of ICS over-therapy in COPD requires a multi-dimensional approach.

Actions (login required)

View Item View Item