Posters

Extract

Practice Research

Clinical pharmacy and pharmacy practice

0021 The impact of smoking status on the efficacy of inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD): a systematic review

K. Sonnex^a,b, H. Alleemudder^a, L-C. Chen^a

^aUniversity of Nottingham, Nottingham, UK, ^bNottingham University Hospitals, Nottingham, UK

Focal points

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Introduction

It has been shown that smoking accelerates the loss in lung function (as measured by forced expiratory volume in 1 second; FEV₁) and increases mortality in Chronic Obstructive Pulmonary Disease (COPD) patients.¹ Later stages of COPD may require regular treatment with inhaled corticosteroids (ICS) in addition to bronchodilators. One of the mechanisms by which ICS exerts its effect is by acting on enzyme histone deacetylase 2 (HDAC2) to suppress the release of inflammatory mediators.² ICS have been shown to reduce exacerbation rates and possibly reduce the decline in FEV₁ in comparison to placebo.¹ However, there is some evidence that smoking inactivates HDAC2, resulting in smokers being resistant to the effects of ICS.² The aim of this research was to conduct a systematic review of the evidence that smoking affects efficacy of ICS in COPD.