Abstract Rationale Corticosteroids are indicated in the treatment of COPD, primarily for exacerbations or selected patients with frequent exacerbations or elevated eosinophils. While nebulized corticosteroids are used in exacerbations, routine use in stable COPD lacks evidence. However, real-world data suggests frequent and combined use. The present study evaluated the prevalence and appropriateness of such prescribing patterns. Methods A multicenter, retrospective study was conducted in 10 centers across Türkiye. The study analyzed COPD prescriptions at discharge following exacerbations and in stable outpatients during routine follow-ups. The data set included demographics, exacerbation history, medication use, eosinophil count, and corticosteroid prescriptions. Results The study comprised 1,715 COPD patients (80.3% male, mean age 68.5 ± 10.5 years), including 869 patients discharged after an exacerbation and 846 stable outpatients. Overall, corticosteroids were prescribed to 73.0% of all patients. Furthermore, corticosteroid prescriptions were observed to be significantly more prevalent among discharged patients than stable outpatients (80.9% vs. 65.1%; p 0.001). In terms of the route of administration of pharmaceuticals, it was found that inhaled corticosteroids (ICS) (with LABA or LABA+LAMA) were administered to 59.6% of patients, while nebulized corticosteroids were administered to 38.4% of patients. A combination of both forms (inhaler and nebulizer) was used by 27.8% of patients, and this combined use was more common in the discharged group than in the stable outpatient group (64.5% vs. 28.5%). Moreover, among the stable outpatients who received corticosteroids (65.1%), only 27.9% met the guideline criteria, such as a history of frequent exacerbations or elevated eosinophil levels. Conclusion The use of corticosteroids in patients with stable COPD is widespread and often unjustified, despite limited evidence, with frequent combined use. The high prescription rate among patients without clear indications raises concerns about adverse effects and healthcare costs. Adherence to guidelines must be improved to optimize treatment and minimize harm. This abstract is funded by: None
Olcay et al. (Fri,) studied this question.