According to a study published in the New England Journal of Medicine called the WISDOM study (Withdrawal of Inhaled Steroids during Optimized Bronchodilator Management), the discontinuance of steroid medications has a negligible effect on COPD patients. The study consisted of more than 2,400 patients that were receiving triple drug therapy for their illness. The study and was first published in late 2014.
The three types of medications for COPD patients in the study were given included a glucocorticoid (steroid), a beta-blocker and an anticholinergic medication. Many doctors prescribe a combination of these three drugs to combat symptoms of COPD. Inhaled steroids have a positive effect on asthma patients, and as a result are also commonly prescribed to treat COPD. As it turns out, adding a steroid drug into the mix doesn’t have much effect on COPD symptoms. In previous studies where steroid efficacy was tested for COPD, withdrawal from the medication was abrupt which can have adverse effects.
Effects of Long-Term Steroid Use
Over time, chronic use of steroids (such as the corticosteroids found in some COPD medications) can weaken the body’s immune system leading to an increased risk of infections, calcium loss from bones, abnormal distribution of body fat, slow wound healing and an increased risk of diabetes. Chronic use of steroids can cause osteoporosis, especially in those that are at higher risk for developing this condition. Furthermore, chronic use of steroids has been known to stunt growth in children.
Steroid-Free COPD Drugs
Stiolro Respimat Inhaler
There are a couple new drugs on the market that combine an anticholinergic drug and a beta blocker into one. These new medications also only need to be inhaled once per day. Stiolto Respimat was approved in 2015. It contains a mix of tiotropium and olodaterol, an anticholinergic and a long-acting beta-blocker combination. Another drug on the market that contains this combination of medications is called Anoro Ellipta. Anoro Ellipta contains umeclidinium (anticholinergic) and vilanterol (beta blocker).
Anoro Ellipta Inhaler
Inhaled anticholinergics like tiotropium, found in Stiolto Respimat, work by inhibiting certain receptors in smooth muscle tissue which causes airways to relax and widen. Inhaled beta blockers also work by relaxing smooth muscle tissue in the airways, but in a different way. They activate certain receptors in the airways which elevates levels of a certain enzyme called cAMP that causes smooth muscle tissue to relax and widen. Using two of these medications together is more effective, as they each take a different approach to opening the airways. It’s similar to the way some people take two different types of blood pressure medications in order to effectively lower blood pressure.
Neither Stiolto Respimat nor Anoro Ellipta are rescue inhalers, meaning they won’t stop an attack once it has started. All patients who suffer from bronchospasms should have a rescue inhaler on hand in the event that they are unable to breathe during an attack. HelpRx carries discount coupons for both of these COPD medications that can save patients as much as 75% off the retail price of Stiolto Respimat or Anoro Ellipta when filling a prescription.
