Effect of high or low-medium accumulated dose regimes of systemic corticosteroids for hospitalised patients with exacerbated chronic obstructive pulmonary disease: pooled analysis of individual participant data from the REDUCE and CORTICO-COP trials
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Effect of high or low-medium accumulated dose regimes of systemic corticosteroids for hospitalised patients with exacerbated chronic obstructive pulmonary disease : pooled analysis of individual participant data from the REDUCE and CORTICO-COP trials. / Sivapalan, Pradeesh; Rutishauser, Jonas; Ulrik, Charlotte Suppli; Leuppi, Jorg D.; Pedersen, Lars; Mueller, Beat; Eklof, Josefin; Biering-Sorensen, Tor; Gottlieb, Vibeke; Armbruster, Karin; Janner, Julie; Moberg, Mia; Lapperre, Therese S.; Nielsen, Thyge L.; Browatzki, Andrea; Mathiousdakis, Alexander; Vestbo, Jorgen; Schuetz, Philipp; Jensen, Jens-Ulrik.
In: European Respiratory Journal. Supplement, Vol. 58, No. Suppl. 65, , OA2946., 2021.Research output: Contribution to journal › Conference abstract in journal › Research
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TY - ABST
T1 - Effect of high or low-medium accumulated dose regimes of systemic corticosteroids for hospitalised patients with exacerbated chronic obstructive pulmonary disease
T2 - 2021 ERS International Congress,
AU - Sivapalan, Pradeesh
AU - Rutishauser, Jonas
AU - Ulrik, Charlotte Suppli
AU - Leuppi, Jorg D.
AU - Pedersen, Lars
AU - Mueller, Beat
AU - Eklof, Josefin
AU - Biering-Sorensen, Tor
AU - Gottlieb, Vibeke
AU - Armbruster, Karin
AU - Janner, Julie
AU - Moberg, Mia
AU - Lapperre, Therese S.
AU - Nielsen, Thyge L.
AU - Browatzki, Andrea
AU - Mathiousdakis, Alexander
AU - Vestbo, Jorgen
AU - Schuetz, Philipp
AU - Jensen, Jens-Ulrik
PY - 2021
Y1 - 2021
N2 - Background: Corticosteroid treatment for acute exacerbations of COPD (AECOPD) reduces the length of hospital stay. Corticosteroid-sparing regimens have showed non-inferiority to higher accumulated dose regimens regarding re-exacerbation risk in patients with AECOPD. However, it remains unknown, if higher accumulated dose regimens as compared to low-medium accumulated dose regimens, leads to shorter admissions and changes in mortality risk. We explored this by analysing the number of days alive and out of hospital (DAOH).Methods: We pooled individual patient data from the two available multicentre RCTs on corticosteroid-sparing regimens for AECOPD: REDUCE (n=314) and CORTICO-COP trial (n=318). Patients randomly allocated to 14 days regimen were compared to 2–5 days regimens, adjusting for confounders.Results: DAOH within 14 days from recruitment was higher for the low–medium (mean 8.3 days;(95%CI) 7.9–8.7) than the high accumulated regimen group (4.2 days; 3.6–4.9;p <.001). High accumulated regime AECOPD group had longer hospital stays, decreased likelihood of discharge within 30 days (HR, 0.6 [0.5–0.7];p<.0001), no differences in the composite endpoint ‘death or ICU admission’ (OR, 1.4 [0.9–2.3];p =.25), new or aggravated hypertension (OR, 1.5 [0.9–2.7]; p=0.15), or mortality risk (HR, 0.8 [0.4–1.5];p= .45) during the 6-month follow-up.Conclusion: Higher corticosteroid dose regimens were associated with longer hospital stays and fewer DAOH within 14 days, with no apparent 6-month benefit regarding death or admission to ICU in COPD patients
AB - Background: Corticosteroid treatment for acute exacerbations of COPD (AECOPD) reduces the length of hospital stay. Corticosteroid-sparing regimens have showed non-inferiority to higher accumulated dose regimens regarding re-exacerbation risk in patients with AECOPD. However, it remains unknown, if higher accumulated dose regimens as compared to low-medium accumulated dose regimens, leads to shorter admissions and changes in mortality risk. We explored this by analysing the number of days alive and out of hospital (DAOH).Methods: We pooled individual patient data from the two available multicentre RCTs on corticosteroid-sparing regimens for AECOPD: REDUCE (n=314) and CORTICO-COP trial (n=318). Patients randomly allocated to 14 days regimen were compared to 2–5 days regimens, adjusting for confounders.Results: DAOH within 14 days from recruitment was higher for the low–medium (mean 8.3 days;(95%CI) 7.9–8.7) than the high accumulated regimen group (4.2 days; 3.6–4.9;p <.001). High accumulated regime AECOPD group had longer hospital stays, decreased likelihood of discharge within 30 days (HR, 0.6 [0.5–0.7];p<.0001), no differences in the composite endpoint ‘death or ICU admission’ (OR, 1.4 [0.9–2.3];p =.25), new or aggravated hypertension (OR, 1.5 [0.9–2.7]; p=0.15), or mortality risk (HR, 0.8 [0.4–1.5];p= .45) during the 6-month follow-up.Conclusion: Higher corticosteroid dose regimens were associated with longer hospital stays and fewer DAOH within 14 days, with no apparent 6-month benefit regarding death or admission to ICU in COPD patients
KW - COPD - exacerbations
KW - Treatments
KW - Pharmacology
U2 - 10.1183/13993003.congress-2021.OA2946
DO - 10.1183/13993003.congress-2021.OA2946
M3 - Conference abstract in journal
VL - 58
JO - European Respiratory Journal. Supplement
JF - European Respiratory Journal. Supplement
SN - 0904-1850
IS - Suppl. 65,
M1 - OA2946.
Y2 - 5 September 2021 through 8 September 2021
ER -
ID: 317959172