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...

Descripción completa

Detalles Bibliográficos
Autores: Miravitlles, Marc, García-Cosío, Borja, Arnedillo, Aurelio, Calle Rubio, Myriam, Alcazar-Navarrete, Bernardino, Gonzalez, Cruz, Esteban, Cristobal, Trigueros, Juan Antonio, Rodriguez Gonzalez-Moro, Jose Miguel, Quintano Jimenez, Jose Antonio, Baloira, Adolfo
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/9555
Acceso en línea:https://hdl.handle.net/20.500.13003/9555
Access Level:acceso abierto
Palabra clave:Pneumonia
Bronchodilator Agents
Withholding Treatment
Humans
Pulmonary Disease, Chronic Obstructive
Adrenal Cortex Hormones
Administration, Inhalation
Randomized Controlled Trials as Topic
Adrenergic beta-2 Receptor Agonists
Privación de Tratamiento
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adrenérgicos beta 2
Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
id ES_bee625f53f8c112b2f11d0f25893382c
oai_identifier_str oai:docusalut.com:20.500.13003/9555
network_acronym_str ES
network_name_str España
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 Rubio, MyriamAlcazar-Navarrete, BernardinoGonzalez, CruzEsteban, CristobalTrigueros, Juan AntonioRodriguez Gonzalez-Moro, Jose MiguelQuintano Jimenez, Jose AntonioBaloira, AdolfoPneumoniaBronchodilator AgentsWithholding TreatmentHumansPulmonary Disease, Chronic ObstructiveAdrenal Cortex HormonesAdministration, InhalationRandomized Controlled Trials as TopicAdrenergic beta-2 Receptor AgonistsPrivación de TratamientoEnfermedad Pulmonar Obstructiva CrónicaBroncodilatadoresHumanosNeumoníaCorticoesteroidesEnsayos Clínicos Controlados Aleatorios como AsuntoAdministración por InhalaciónAgonistas de Receptores Adrenérgicos beta 2AlgorithmChronic obstructive pulmonary diseaseExacerbationsInhaled corticosteroidsLung functionAccording 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.BMC20172017-11-2820172017-11-28review articlehttp://purl.org/coar/resource_type/c_dcae04bcinfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/9555reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/95552026-06-22T12:44:07Z
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
Pneumonia
Bronchodilator Agents
Withholding Treatment
Humans
Pulmonary Disease, Chronic Obstructive
Adrenal Cortex Hormones
Administration, Inhalation
Randomized Controlled Trials as Topic
Adrenergic beta-2 Receptor Agonists
Privación de Tratamiento
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adrenérgicos beta 2
Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
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 Rubio, Myriam
Alcazar-Navarrete, Bernardino
Gonzalez, Cruz
Esteban, Cristobal
Trigueros, Juan Antonio
Rodriguez Gonzalez-Moro, Jose Miguel
Quintano Jimenez, Jose Antonio
Baloira, Adolfo
author Miravitlles, Marc
author_facet Miravitlles, Marc
García-Cosío, Borja
Arnedillo, Aurelio
Calle Rubio, Myriam
Alcazar-Navarrete, Bernardino
Gonzalez, Cruz
Esteban, Cristobal
Trigueros, Juan Antonio
Rodriguez Gonzalez-Moro, Jose Miguel
Quintano Jimenez, Jose Antonio
Baloira, Adolfo
author_role author
author2 García-Cosío, Borja
Arnedillo, Aurelio
Calle Rubio, Myriam
Alcazar-Navarrete, Bernardino
Gonzalez, Cruz
Esteban, Cristobal
Trigueros, Juan Antonio
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 Pneumonia
Bronchodilator Agents
Withholding Treatment
Humans
Pulmonary Disease, Chronic Obstructive
Adrenal Cortex Hormones
Administration, Inhalation
Randomized Controlled Trials as Topic
Adrenergic beta-2 Receptor Agonists
Privación de Tratamiento
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adrenérgicos beta 2
Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
topic Pneumonia
Bronchodilator Agents
Withholding Treatment
Humans
Pulmonary Disease, Chronic Obstructive
Adrenal Cortex Hormones
Administration, Inhalation
Randomized Controlled Trials as Topic
Adrenergic beta-2 Receptor Agonists
Privación de Tratamiento
Enfermedad Pulmonar Obstructiva Crónica
Broncodilatadores
Humanos
Neumonía
Corticoesteroides
Ensayos Clínicos Controlados Aleatorios como Asunto
Administración por Inhalación
Agonistas de Receptores Adrenérgicos beta 2
Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
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
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 https://hdl.handle.net/20.500.13003/9555
url https://hdl.handle.net/20.500.13003/9555
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.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Docusalut
instname:Conselleria de Salut i Consum del Govern de les Illes Balears
instname_str Conselleria de Salut i Consum del Govern de les Illes Balears
reponame_str Docusalut
collection Docusalut
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869418323438993408
score 15,808905

Similares en LA Referencia