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 β agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS are l...

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Autores: Miravitlles, Marc|||0000-0002-9850-9520, Cosio, Borja G.|||0000-0002-6388-8209, Arnedillo, Aurelio, Calle Rubio, Myriam|||0000-0002-3890-2742, Alcázar-Navarrete, Bernardino|||0000-0003-2356-9366, González, Cruz, Esteban, Cristóbal, Trigueros, Juan Antonio, Rodríguez González-Moro, José Miguel|||0000-0002-8446-3373, Quintano Jiménez, José Antonio, Baloira, Adolfo
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:254051
Acceso en línea:https://ddd.uab.cat/record/254051
https://dx.doi.org/urn:doi:10.1186/s12931-017-0682-y
Access Level:acceso abierto
Palabra clave:Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
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spelling A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary diseaseMiravitlles, Marc|||0000-0002-9850-9520Cosio, Borja G.|||0000-0002-6388-8209Arnedillo, AurelioCalle Rubio, Myriam|||0000-0002-3890-2742Alcázar-Navarrete, Bernardino|||0000-0003-2356-9366González, CruzEsteban, CristóbalTrigueros, Juan AntonioRodríguez González-Moro, José Miguel|||0000-0002-8446-3373Quintano Jiménez, José AntonioBaloira, AdolfoAlgorithmChronic 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 β 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.Universitat Autònoma de Barcelona 22017-01-0120172017-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/254051https://dx.doi.org/urn:doi:10.1186/s12931-017-0682-yreponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2540512026-06-06T12:50:31Z
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|||0000-0002-9850-9520
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|||0000-0002-9850-9520
Cosio, Borja G.|||0000-0002-6388-8209
Arnedillo, Aurelio
Calle Rubio, Myriam|||0000-0002-3890-2742
Alcázar-Navarrete, Bernardino|||0000-0003-2356-9366
González, Cruz
Esteban, Cristóbal
Trigueros, Juan Antonio
Rodríguez González-Moro, José Miguel|||0000-0002-8446-3373
Quintano Jiménez, José Antonio
Baloira, Adolfo
author Miravitlles, Marc|||0000-0002-9850-9520
author_facet Miravitlles, Marc|||0000-0002-9850-9520
Cosio, Borja G.|||0000-0002-6388-8209
Arnedillo, Aurelio
Calle Rubio, Myriam|||0000-0002-3890-2742
Alcázar-Navarrete, Bernardino|||0000-0003-2356-9366
González, Cruz
Esteban, Cristóbal
Trigueros, Juan Antonio
Rodríguez González-Moro, José Miguel|||0000-0002-8446-3373
Quintano Jiménez, José Antonio
Baloira, Adolfo
author_role author
author2 Cosio, Borja G.|||0000-0002-6388-8209
Arnedillo, Aurelio
Calle Rubio, Myriam|||0000-0002-3890-2742
Alcázar-Navarrete, Bernardino|||0000-0003-2356-9366
González, Cruz
Esteban, Cristóbal
Trigueros, Juan Antonio
Rodríguez González-Moro, José Miguel|||0000-0002-8446-3373
Quintano Jiménez, José Antonio
Baloira, Adolfo
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Algorithm
Chronic obstructive pulmonary disease
Exacerbations
Inhaled corticosteroids
Lung function
topic 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 β 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 2
2017-01-01
2017
2017-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/254051
https://dx.doi.org/urn:doi:10.1186/s12931-017-0682-y
url https://ddd.uab.cat/record/254051
https://dx.doi.org/urn:doi:10.1186/s12931-017-0682-y
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
https://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
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,298079

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