Source: International Congress 2014 – Management of asthma and other respiratory diseases in primary care
Disease area: Airway diseases

Abstract

Intro: A 2012 provincial Canadian database study (1) including 160,000 COPD patients concluded that ICS increases the risk of serious pneumonia in COPD patients1. How this article and knowledge has impacted the practice of family physicians (FP) and respirologists (RESP) remains unknown.Aim: To better understand how physicians perceive the role of ICS in the management of COPD.Methods: 45 minutes online survey; FP (n=75) and RESP (n=40) across Canada. Complementary questions were asked during 45 separate one-on-one interviews to understand perception of safety and efficacy around ICS.Results: Concerns around ICS were common amongst FP and RESP; the most common being the risk of pneumonia There was a lower level concern regarding other COPD co-morbities such as diabetes, osteoporosis and glaucoma. However, some physicians remained skeptical on the direct correlation between osteoporosis and inhaled corticosteroid. Overall, FP at 59% and RESP at 53% confirmed that ICS usage should decrease for the treatment of COPD, alone or in combination with a LABA. FP at 76% and RESP at 78% admitted that a possible solution could be to change treatment of symptomatic patients from ICS/LABA FDC to a LABA/LAMA combination, once this new class is available.Conclusion: The raised awareness around risk linked to long-term usage of ICS coupled with the questionable benefit of ICS in non-exacerbating COPD patients may well lead to a future decrease in usage of ICS in COPD management.1-Suissa S, et al. Thorax 2013;68:1029–1036. doi:10.1136/thoraxjnl-2012-202872 1029.

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Citations should be made in the following way:
A. Kaplan, M. A. Cyr (Toronto, Montreal, Canada). Canadian physicians are concerned about the use of inhaled corticosteroids (ICS) in COPD management. Eur Respir J 2014; 44: Suppl. 58, 3030

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