Trial reportRespiratory research2020
Reduced risk of clinically important deteriorations by ICS in COPD is eosinophil dependent: a pooled post-hoc analysis.
Trial report in Respiratory research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Clinically Important Deterioration (CID) and Ageing in COPD: A Systematic Review and Meta-Regression Analysis According to PRISMA Statement.International journal of chronic obstructive pulmonary disease · 2023Pooled it
- Eosinophil biology in COPD: from scientific insight to clinical treatment action.ERJ open research · 2026Review
- Clinically important deterioration in a mild-moderate COPD population.ERJ open research · 2025Article
- A Delphi Consensus Project to Capture Greek Experts' Opinion on the Position of Triple Therapies in COPD: Why, When and to Whom.International journal of chronic obstructive pulmonary disease · 2025Article
- Inflammatory cells and remodeling in bronchial biopsies from COPD patients and controls.PloS one · 2025Article
- Time-Updated Phenotypic Guidance of Corticosteroids and Antibiotics in COPD: Rationale, Perspective and a Proposed Method.Biomedicines · 2023Review
- Patients with Chronic Obstructive Pulmonary Disease and Evidence of Eosinophilic Inflammation Experience Exacerbations Despite Receiving Maximal Inhaled Maintenance Therapy.International journal of chronic obstructive pulmonary disease · 2022Observational
- Towards precision in defining COPD exacerbations.Breathe (Sheffield, England) · 2021Review
- One-year clinically important deterioration and long-term clinical course in Japanese patients with COPD: a multicenter observational cohort study.BMC pulmonary medicine · 2021Observational
- Prognostic value of clinically important deterioration in COPD: IMPACT trial analysis.ERJ open research · 2021Article
- Integrating Comorbidities and Phenotype-Based Medicine in Patient-Centered Medicine in COPD.Journal of clinical medicine · 2020Review
- Dual Bronchodilator in the Era of Triple Therapy.International journal of chronic obstructive pulmonary disease · 2020Review
- Modified and simplified clinically important deterioration: multidimensional indices of short-term disease trajectory to predict future exacerbations in patients with chronic obstructive pulmonary disease.Therapeutic advances in respiratory diseaseObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundClinically Important Deterioration (CID) is a novel composite measure to assess treatment effect in chronic obstructive pulmonary disease (COPD). We examined the performance and utility of CID in assessing the effect of inhaled corticosteroids (ICS) in COPD.
methodsThis post-hoc analysis of four budesonide/formoterol (BUD/FORM) studies comprised 3576 symptomatic moderate-to-very-severe COPD patients with a history of exacerbation. Analysis of time to first CID event (exacerbation, deterioration in forced expiratory volume in 1 second [FEV
resultsThe proportion of patients with ≥1 CID in the four studies ranged between 63 and 77% and 69-84% with BUD/FORM and FORM, respectively, with an average 25% reduced risk of CID with BUD/FORM. All components contributed to the CID event rate. Experiencing a CID during the first 3 months was associated with poorer outcomes (lung function, quality of life, symptoms and reliever use) and increased risk of later CID events. The effect of BUD/FORM versus FORM in reducing CID risk was positively associated with the blood eosinophil count.
conclusionsOur findings suggest that BUD/FORM offers protective effects for CID events compared with FORM alone, with the magnitude of the effect dependent on patients' eosinophil levels. CID may be an important tool for evaluation of treatment effect in a complex, multifaceted, and progressive disease like COPD, and a valuable tool to allow for shorter and smaller future outcome predictive trials in early drug development.
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Registered trials
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.