A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease

According to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting beta(2) agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS...

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Detalles Bibliográficos
Autores: Miravitlles, Marc, García-Cosío, Borja, Arnedillo, Aurelio, Calle, Myriam, Alcazar-Navarrete, Bernardino, Gonzalez, Cruz, Esteban, Cristobal, Antonio Trigueros, Juan, Rodriguez Gonzalez-Moro, Jose Miguel, Quintano Jimenez, Jose Antonio, Baloira, Adolfo
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/20464
Acceso en línea:http://hdl.handle.net/20.500.12105/20464
Access Level:acceso abierto
Palabra clave:Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adren�rgicos beta 2
Privación de Tratamiento
Adrenergic beta-2 Receptor Agonists
Randomized Controlled Trials as Topic
Administration, Inhalation
Adrenal Cortex Hormones
Pulmonary Disease, Chronic Obstructive
Humans
Withholding Treatment
Bronchodilator Agents
Pneumonia
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network_acronym_str ES
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repository_id_str
spelling A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary diseaseMiravitlles, MarcGarcía-Cosío, BorjaArnedillo, AurelioCalle, MyriamAlcazar-Navarrete, BernardinoGonzalez, CruzEsteban, CristobalAntonio Trigueros, JuanRodriguez Gonzalez-Moro, Jose MiguelQuintano Jimenez, Jose AntonioBaloira, AdolfoAlgorithmChronic obstructive pulmonary diseaseExacerbationsInhaled corticosteroidsLung functionEnfermedad Pulmonar Obstructiva CrónicaBroncodilatadoresHumanosNeumoníaCorticoesteroidesEnsayos Clínicos Controlados Aleatorios como AsuntoAdministración por InhalaciónAgonistas de Receptores Adren�rgicos beta 2Privación de TratamientoAdrenergic beta-2 Receptor AgonistsRandomized Controlled Trials as TopicAdministration, InhalationAdrenal Cortex HormonesPulmonary Disease, Chronic ObstructiveHumansWithholding TreatmentBronchodilator AgentsPneumoniaAccording to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting beta(2) agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS are largely overprescribed in clinical practice, and most patients are unlikely to benefit from long-term ICS therapy. Evidence from recent randomized-controlled trials supports the hypothesis that ICS can be safely and effectively discontinued in patients with stable COPD and in whom ICS therapy may not be indicated, without detrimental effects on lung function, health status, or risk of exacerbations. This article summarizes the evidence supporting the discontinuation of ICS therapy, and proposes an algorithm for the implementation of ICS withdrawal in patients with COPD in clinical practice. Given the increased risk of potentially serious adverse effects and complications with ICS therapy (including pneumonia), the use of ICS should be limited to the minority of patients in whom the treatment effects outweigh the risks.BioMed Central (BMC)20242024-07-1120172017-11-2820172017-11-28review articlehttp://purl.org/coar/resource_type/c_dcae04bcinfo:eu-repo/semantics/articlehttp://hdl.handle.net/20.500.12105/20464reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/204642026-06-12T12:43:37Z
dc.title.none.fl_str_mv A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
title A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
spellingShingle A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
Miravitlles, Marc
Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adren�rgicos beta 2
Privación de Tratamiento
Adrenergic beta-2 Receptor Agonists
Randomized Controlled Trials as Topic
Administration, Inhalation
Adrenal Cortex Hormones
Pulmonary Disease, Chronic Obstructive
Humans
Withholding Treatment
Bronchodilator Agents
Pneumonia
title_short A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
title_full A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
title_fullStr A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
title_full_unstemmed A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
title_sort A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
dc.creator.none.fl_str_mv Miravitlles, Marc
García-Cosío, Borja
Arnedillo, Aurelio
Calle, Myriam
Alcazar-Navarrete, Bernardino
Gonzalez, Cruz
Esteban, Cristobal
Antonio Trigueros, Juan
Rodriguez Gonzalez-Moro, Jose Miguel
Quintano Jimenez, Jose Antonio
Baloira, Adolfo
author Miravitlles, Marc
author_facet Miravitlles, Marc
García-Cosío, Borja
Arnedillo, Aurelio
Calle, Myriam
Alcazar-Navarrete, Bernardino
Gonzalez, Cruz
Esteban, Cristobal
Antonio Trigueros, Juan
Rodriguez Gonzalez-Moro, Jose Miguel
Quintano Jimenez, Jose Antonio
Baloira, Adolfo
author_role author
author2 García-Cosío, Borja
Arnedillo, Aurelio
Calle, Myriam
Alcazar-Navarrete, Bernardino
Gonzalez, Cruz
Esteban, Cristobal
Antonio Trigueros, Juan
Rodriguez Gonzalez-Moro, Jose Miguel
Quintano Jimenez, Jose Antonio
Baloira, Adolfo
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adren�rgicos beta 2
Privación de Tratamiento
Adrenergic beta-2 Receptor Agonists
Randomized Controlled Trials as Topic
Administration, Inhalation
Adrenal Cortex Hormones
Pulmonary Disease, Chronic Obstructive
Humans
Withholding Treatment
Bronchodilator Agents
Pneumonia
topic Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adren�rgicos beta 2
Privación de Tratamiento
Adrenergic beta-2 Receptor Agonists
Randomized Controlled Trials as Topic
Administration, Inhalation
Adrenal Cortex Hormones
Pulmonary Disease, Chronic Obstructive
Humans
Withholding Treatment
Bronchodilator Agents
Pneumonia
description According to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting beta(2) agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS are largely overprescribed in clinical practice, and most patients are unlikely to benefit from long-term ICS therapy. Evidence from recent randomized-controlled trials supports the hypothesis that ICS can be safely and effectively discontinued in patients with stable COPD and in whom ICS therapy may not be indicated, without detrimental effects on lung function, health status, or risk of exacerbations. This article summarizes the evidence supporting the discontinuation of ICS therapy, and proposes an algorithm for the implementation of ICS withdrawal in patients with COPD in clinical practice. Given the increased risk of potentially serious adverse effects and complications with ICS therapy (including pneumonia), the use of ICS should be limited to the minority of patients in whom the treatment effects outweigh the risks.
publishDate 2017
dc.date.none.fl_str_mv 2017
2017-11-28
2017
2017-11-28
2024
2024-07-11
dc.type.none.fl_str_mv review article
http://purl.org/coar/resource_type/c_dcae04bc
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/20464
url http://hdl.handle.net/20.500.12105/20464
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central (BMC)
publisher.none.fl_str_mv BioMed Central (BMC)
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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