Please use this identifier to cite or link to this item: doi:10.22028/D291-37465
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Title: Treatment of COPD Groups GOLD A and B with Inhaled Corticosteroids in the COSYCONET Cohort : Determinants and Consequences
Author(s): Lutter, Johanna I.
Jörres, Rudolf A.
Trudzinski, Franziska C.
Alter, Peter
Kellerer, Christina
Watz, Henrik
Welte, Tobias
Bals, Robert
Kauffmann-Guerrero, Diego
Behr, Jürgen
Holle, Rolf
F Vogelmeier, Claus
Kahnert, Kathrin
Language: English
Title: International Journal of Chronic Obstructive Pulmonary Disease
Volume: 2021
Issue: 16
Pages: 987-998
Publisher/Platform: DOVE
Year of Publication: 2021
Free key words: COPD
inhaled corticosteroids
GOLD groups
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: 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€ 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.
DOI of the first publication: 10.2147/COPD.S304532
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-374653
ISSN: 1178-2005
Date of registration: 30-Sep-2022
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Prof. Dr. Robert Bals
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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