Evidence map›Paper›PMID 30903196›Full record

ArticleEuropean journal of clinical pharmacology2019

Discontinuation of therapy among COPD patients who experience an improvement in exacerbation status.

Mette Reilev, Kasper Bruun Kristensen, Jens Søndergaard, Daniel Pilsgaard Henriksen, Wade Thompson, Anton Pottegård

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Article in European journal of clinical pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mette ReilevClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense C, Denmark. mreilev@health.sdu.dk.ORCID http://orcid.org/0000-0003-1241-4385
Kasper Bruun KristensenClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense C, Denmark.
Jens SøndergaardResearch Unit of General Practice, Department of Public Health, University of Southern Denmark, JB Winsløwsvej 19, 2, 5000, Odense C, Denmark.
Daniel Pilsgaard HenriksenDepartment of Clinical Biochemistry & Pharmacology, Odense University Hospital, Odense C, Denmark.
Wade ThompsonResearch Unit of General Practice, Department of Public Health, University of Southern Denmark, JB Winsløwsvej 19, 2, 5000, Odense C, Denmark.
Anton PottegårdClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense C, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA subset of patients with chronic obstructive pulmonary disease (COPD) experience a decrease in exacerbation frequency, leading to a diminished need for treatment with inhaled corticosteroids (ICS). We investigated prescribing and discontinuation patterns of long-acting bronchodilators and ICS in COPD patients according to exacerbation frequency.

methodsUsing the nationwide Danish health registries, we conducted a drug utilization study among patients who had at least two exacerbations or one hospitalization due to an exacerbation during 2011-2012. This study population was stratified according to consistency of exacerbation occurrence after 12, 24, 36, and 48 months of follow-up and the groups were described according to use of ICS, long-acting β

resultsWe identified 29,010 COPD exacerbators during 2011-2012. Upon inclusion, 70% received ICS-containing regimens, in combination with LABA (23%) or both LABA and LAMA (41%). The proportion of prevalent users of ICS-containing regimens decreased to 56% during follow-up among exacerbation-free individuals, while it increased to 86% in individuals who experienced at least one exacerbation annually. Persistence to ICS-containing regimens was 58% after 4 years in individuals without exacerbations compared to 74% among those with annual exacerbations. Similar patterns were observed for triple therapy which was the most extensively used drug combination regardless of consistency of exacerbation occurrence.

conclusionsThe extensive use of ICS and the relatively high persistence to ICS-containing regimens in individuals who had a decrease in exacerbation occurrence highlight a need for the development and implementation of de-escalation strategies in clinical practice.

Indexed as

Administration, InhalationAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsAgedAged, 80 and overDenmarkDisease ProgressionDrug Therapy, CombinationFemaleHospitalizationHumansMaleMuscarinic AntagonistsPulmonary Disease, Chronic ObstructiveSeverity of Illness IndexTreatment OutcomeAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsMuscarinic AntagonistsCOPDInhaled corticosteroidsLong-acting bronchodilatorsPharmacoepidemiologyUtilization patterns

Identifiers

PMID30903196

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.