Safe withdrawal of inhaled steroids in mild or moderate COPD (SWAP)

  • Research type

    Research Study

  • Full title

    Feasibility of the safe withdrawal of inhaled corticosteroids in patients with mild to moderate COPD prescribed outside guidelines (SWAP)

  • IRAS ID

    172251

  • Contact name

    Patrick White

  • Contact email

    patrick.white@kcl.ac.uk

  • Sponsor organisation

    King's College London

  • Eudract number

    2016-001876-31

  • Duration of Study in the UK

    1 years, 9 months, 30 days

  • Research summary

    Chronic obstructive pulmonary disease (COPD) is the modern term for the diseases of chronic bronchitis and emphysema. Patients with severe or very severe COPD may benefit from using high dose inhaled corticosteroid drugs. There is evidence of widespread over-prescribing of these drugs to patients with mild or moderate COPD in many countries. These drugs can increase the risk to patients of developing pneumonia (an estimated extra 3000 cases per year in England), fractures and cataracts. In most patients with mild or moderate COPD there is no evidence of any benefit from high dose inhaled corticosteroids. The drugs prescribed to patients with mild or moderate COPD are costly. In the NHS in England an estimated £122 million is spent each year in prescribing high dose inhaled corticosteroids in mild and moderate COPD, approximately 20% of the total spend on these drugs. Little is known of patients’ perceptions towards the proposed withdrawal of these drugs when prescribed for mild or moderate COPD. This research will examine the feasibility of carrying out a trial of withdrawing these high dose inhaled corticosteroids in patients with mild or moderate COPD. In the trial for which this is a feasibility study we will assess whether withdrawal of high dose inhaled corticosteroids has any impact on patients' quality of life, lung function, exacerbation frequency, markers of inflammation in the blood, or evidence of interference with breathlessness. We will assess whether patients and practices find this research acceptable and safe. If they do we will be able to proceed later with a definitive trial of the withdrawal of high dose inhaled corticosteroids.

  • REC name

    London - London Bridge Research Ethics Committee

  • REC reference

    16/LO/1696

  • Date of REC Opinion

    26 Oct 2016

  • REC opinion

    Further Information Favourable Opinion