TY - JOUR T1 - Discontinuing inhaled steroids might not be safe in severe COPD cases JF - Evidence Based Medicine JO - Evid Based Med SP - 57 LP - 57 DO - 10.1136/ebmed-2014-110124 VL - 20 IS - 2 AU - Rafael Laniado-Laborín Y1 - 2015/04/01 UR - http://ebm.bmj.com/content/20/2/57.abstract N2 - Commentary on: Magnussen H, Disse B, Rodriguez-Roisin R, et al; WISDOM Investigators. Withdrawal of inhaled glucocorticoids and exacerbations of COPD. N Engl J Med 2014;371:1285–94.OpenUrlCrossRefPubMedWeb of ScienceRecommended treatment for chronic obstructive pulmonary disease (COPD) in patients with frequent exacerbations include a combination of a long-acting bronchodilator (LAB) and inhaled corticosteroids (ICS). The extra benefit on exacerbation rate of adding ICS to a dual LAB regimen has never been determined in an adequately powered trial. The authors conducted a randomised, double-blind, clinical trial to test their hypothesis that ICS could be withdrawn without increasing the frequency of exacerbations in COPD, as long as the patients were still treated with a combination of LAB (tiotropium and salmeterol).This 1-year, non-inferiority trial included 2485 patients, 40 years or older with severe … ER -