The dose of inhaled corticosteroids in patients with COPD: when less is better
José Luis Izquierdo,1 Borja G Cosio2,3 1Department of Pneumology and Medicine, Hospital Universitario, Universidad de Alcalá, Guadalajara, Spain; 2Department of Respiratory Medicine, Hospital Son Espases-IdISBa, Palma de Mallorca, Spain; 3CIBER de Enfermedades Respiratorias (C...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-10-01
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| Series: | International Journal of COPD |
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| Online Access: | https://www.dovepress.com/the-dose-of-inhaled-corticosteroids-in-patients-with-copd-when-less-is-peer-reviewed-article-COPD |
| _version_ | 1828490285391282176 |
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| author | Izquierdo JL Cosio BG |
| author_facet | Izquierdo JL Cosio BG |
| author_sort | Izquierdo JL |
| collection | DOAJ |
| description | José Luis Izquierdo,1 Borja G Cosio2,3 1Department of Pneumology and Medicine, Hospital Universitario, Universidad de Alcalá, Guadalajara, Spain; 2Department of Respiratory Medicine, Hospital Son Espases-IdISBa, Palma de Mallorca, Spain; 3CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain Background: The use of inhaled corticosteroids (ICS) in combination with bronchodilators in patients with COPD has been shown to decrease the rate of disease exacerbations and to improve the lung function and patients’ quality of life. However, their use has also been associated with an increased risk of pneumonia. Materials and methods: We have reviewed existing clinical evidence on the risks and benefits of ICS in COPD, including large randomized clinical trials, meta-analyses, and clinical reviews. Results: A large body of evidence supports the clinical benefits of ICS in patients with COPD in terms of exacerbations, symptoms, lung function, and quality of life. The incidence of adverse events related to ICS, including pneumonia, varies strongly among the studies and seems to be dose dependent, with recent well-designed, large studies on low-dose ICS reporting similar safety profiles in ICS and non-ICS groups. Conclusion: The benefits of ICS in COPD continue to outweigh the risks, especially when lower ICS doses are employed. Given that the data on ICS withdrawal in COPD are scarce and conflicting, we argue that using reduced doses of ICS could be an optimal strategy to manage patients with COPD. Keywords: acute exacerbations, anti-inflammatory effects, COPD, asthma-COPD overlap syndrome, inhaled corticosteroids, lower doses of ICS, pneumonia |
| first_indexed | 2024-12-11T10:40:48Z |
| format | Article |
| id | doaj.art-ddd0a188c8e240f8a158f8f02c18e84b |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-11T10:40:48Z |
| publishDate | 2018-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-ddd0a188c8e240f8a158f8f02c18e84b2022-12-22T01:10:35ZengDove Medical PressInternational Journal of COPD1178-20052018-10-01Volume 133539354741751The dose of inhaled corticosteroids in patients with COPD: when less is betterIzquierdo JLCosio BGJosé Luis Izquierdo,1 Borja G Cosio2,3 1Department of Pneumology and Medicine, Hospital Universitario, Universidad de Alcalá, Guadalajara, Spain; 2Department of Respiratory Medicine, Hospital Son Espases-IdISBa, Palma de Mallorca, Spain; 3CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain Background: The use of inhaled corticosteroids (ICS) in combination with bronchodilators in patients with COPD has been shown to decrease the rate of disease exacerbations and to improve the lung function and patients’ quality of life. However, their use has also been associated with an increased risk of pneumonia. Materials and methods: We have reviewed existing clinical evidence on the risks and benefits of ICS in COPD, including large randomized clinical trials, meta-analyses, and clinical reviews. Results: A large body of evidence supports the clinical benefits of ICS in patients with COPD in terms of exacerbations, symptoms, lung function, and quality of life. The incidence of adverse events related to ICS, including pneumonia, varies strongly among the studies and seems to be dose dependent, with recent well-designed, large studies on low-dose ICS reporting similar safety profiles in ICS and non-ICS groups. Conclusion: The benefits of ICS in COPD continue to outweigh the risks, especially when lower ICS doses are employed. Given that the data on ICS withdrawal in COPD are scarce and conflicting, we argue that using reduced doses of ICS could be an optimal strategy to manage patients with COPD. Keywords: acute exacerbations, anti-inflammatory effects, COPD, asthma-COPD overlap syndrome, inhaled corticosteroids, lower doses of ICS, pneumoniahttps://www.dovepress.com/the-dose-of-inhaled-corticosteroids-in-patients-with-copd-when-less-is-peer-reviewed-article-COPDAcute exacerbationsanti-inflammatory effectsCOPDasthma-COPD overlap syndromeinhaled corticosteroids (ICS)lower doses of ICSpneumonia |
| spellingShingle | Izquierdo JL Cosio BG The dose of inhaled corticosteroids in patients with COPD: when less is better International Journal of COPD Acute exacerbations anti-inflammatory effects COPD asthma-COPD overlap syndrome inhaled corticosteroids (ICS) lower doses of ICS pneumonia |
| title | The dose of inhaled corticosteroids in patients with COPD: when less is better |
| title_full | The dose of inhaled corticosteroids in patients with COPD: when less is better |
| title_fullStr | The dose of inhaled corticosteroids in patients with COPD: when less is better |
| title_full_unstemmed | The dose of inhaled corticosteroids in patients with COPD: when less is better |
| title_short | The dose of inhaled corticosteroids in patients with COPD: when less is better |
| title_sort | dose of inhaled corticosteroids in patients with copd when less is better |
| topic | Acute exacerbations anti-inflammatory effects COPD asthma-COPD overlap syndrome inhaled corticosteroids (ICS) lower doses of ICS pneumonia |
| url | https://www.dovepress.com/the-dose-of-inhaled-corticosteroids-in-patients-with-copd-when-less-is-peer-reviewed-article-COPD |
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