Stopping COPD Meds May Cause Withdrawl Effects

Featured Buzz – January 26, 2026

British researchers who conducted a post-hoc analysis of data from the FLAME trial found that COPD patients who stop treatment with long-acting muscarinic antagonists (LAMA) or inhaled corticosteroids (ICS) are at increased risk of exacerbations in the first quarter after discontinuing treatment.

Participants in the study, which compared outcomes among patients taking either a long-acting beta-2 agonist (LABA) plus LAMA or LAMA plus ICS, had moderate-to-severe COPD and a history of exacerbations. Results showed:

• A marked, transient increase in moderate-to-severe exacerbations, but not severe exacerbations, during the first vs. subsequent quarters in patients who discontinued LAMA.
• A significant early rise in severe exacerbations, but not moderate-to-severe events, in participants who discontinued ICS.
• A potential strong LAMA withdrawal effect among participants who were only receiving LAMA or ICS at baseline.
• ICS withdrawal effects appeared consistent regardless of baseline blood eosinophil count and persisted beyond four weeks.
• A sensitivity analysis conducted among participants who completed 300 or more days of trial treatment showed early, but less pronounced, peaks in exacerbations.

The investigators believe these findings suggest clinicians should carefully monitor medication adherence at every visit and increase awareness among patients and colleagues alike about the risk of treatment withdrawal effects.

“Our findings suggest potent LAMA and ICS treatment withdrawal effects on exacerbations, highlighting the importance of treatment adherence and accounting for withdrawal effects in clinical trials,” they wrote.

The study was published in Thorax.

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