Overview
Clinical trial on eosinophil-guided time-updated person-specific reduction of inhaled corticosteroid (ICS) therapy and prophylactic azithromycin therapy in patients with severe or very severe chronic obstructive pulmonary disease (COPD) receiving long-acting b-agonist (LABA) / long-acting muscarinic receptor antagonists (LAMA) / ICS treatment.
Eligibility
Inclusion Criteria:
- COPD (verified by a specialist in respiratory medicine + spirometry)
- GOLD risk class C/D anytime within the last 2 years (corresponding to 2 ≥ AECOPD and/or ≥1 AECOPD leading to hospitalization during a 12 months period within the last 2 years) and/or FEV1<30%.
- Must receive at least during last 4 weeks: LAMA, LABA and ICS
- Informed consent
Exclusion Criteria:
- Known asthma.
- Male < 40 years.
- Female <40 years, if non-menopausal (had menstruation within the last 12 months) conditioned by a negative urine HCG test
- Severe mental illness which considerably complicates co-operation.
- Language problems that considerably complicate co-operation.
- Current treatment with systemic corticosteroids corresponding to > 5 mg prednisolone per day.
- Systemic antibiotic treatment or systemic corticosteroid treatment within 14 days (also prophylactic Azithromycin).
- Contra-indication to treat with Azithromycin (as listed by the producer).
- Non-bacterial exacerbation per investigator judgement in the last 3 months.