INvestigating COPD Outcomes, Genomics and Neutrophilic Inflammation with Tiotropium and Olodaterol.
Inhaled corticosteroids (ICS) reduce exacerbation frequency in Chronic Obstructive Pulmonary Disease (COPD) patients with eosinophilic inflammation but increase the risk of pneumonia. This multi-centre randomised open label controlled parallel group trial investigated the effect of ICS withdrawal on airway bacterial load, the airway microbiome and airway inflammation in non-eosinophilic COPD. Participants had a diagnosis of COPD and a blood eosinophil count less than 300 cells per microlitre and were currently treated with ICS, and were randomised to either Tiotropium and Olodaterol (ICS withdrawal) or Fluticasone Furoate and Vilanterol (ICS continuation) for 6 months. Sputum, oropharyngeal and nasopharyngeal samples were collected at 0, 1, 2, 3 and 6 months.