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In the treatment of chronic obstructive pulmonary disease, inhaled corticosteroids have a certain position, such as in combination with long-acting bronchodilator, based on 1 second forced expiratory volume (FEV1) <60% of patients with acute exacerbation frequency (A Evidence). Previous studies have also shown that in some patients, removal of inhaled glucocorticoids may lead to acute exacerbations in patients. Therefore, in the treatment of chronic obstructive pulmonary disease, long-term inhaled glucocorticoid phenomenon has become a global problem. "Worldwide, more than 70% of patients with COPD use inhaled corticosteroids, and bronchodilators, which are used as a basis for COPD," said Helgo Magnussen, lead author of the WISDOM study and professor at the University of Bonn in Germany. "However, the inclusion of new GOLD guidelines in the WISDOM study confirmed that patients receiving tiotropium bromide(136310-93-5) and salmeterol in patients with severe chronic obstructive pulmonary disease, within 3 months of gradual removal of inhaled glucocorticoid patients in the treatment group did not increase the risk of acute exacerbation of moderate to severe chronic obstructive pulmonary disease compared with the continuation group. Routine use of inhaled glucocorticoids did not affect long-term FEV1 or mortality in patients with chronic obstructive pulmonary disease (type A evidence). 

HelgoMagnussen at the meeting and share the WISDOM study results, the study is a double-blind, parallel-controlled study in 210 centers in 20 countries, more than 2,400 patients underwent tiotropium bromide(136310-93-5), salmeterol and Inhaled glucocorticoid fluticasone propionate triple therapy treatment, the results in September 2014 published in the "New England Journal of Medicine" on. The results showed that there was no difference in the reduction of pulmonary function between the inhaled glucocorticoid group and the inhaled glucocorticoid group from 250 to 100 micrograms in the first 12 weeks of the study and from 12 to 18 weeks in the inhaled glucocorticoid group from 100 micrograms and a reduction in lung function of 38 ml, but decreased by less than 4% compared with baseline values ??of 981 ml; and complete withdrawal of inhaled corticosteroids from 18 to 52 weeks group lung function decreased more than 5 ml, and no withdrawal of the hormone group was almost the same slope, pulmonary function remained stable. The primary clinical end point of the WISDOM study was to observe the onset of acute exacerbations rather than pulmonary function, although there was no statistically significant difference between 4% of the hormone withdrawal groups, but there was no statistically significant difference between the two groups.

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