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Respiratory Research
Published in: Respiratory Research 1/2017

Open Access 01-12-2017 | Review

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

Authors: Marc Miravitlles, Borja G. Cosío, Aurelio Arnedillo, Myriam Calle, Bernardino Alcázar-Navarrete, Cruz González, Cristóbal Esteban, Juan Antonio Trigueros, José Miguel Rodríguez González-Moro, José Antonio Quintano Jiménez, Adolfo Baloira

Published in: Respiratory Research | Issue 1/2017

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Abstract

According to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting β2 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.
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Metadata
Title
A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
Authors
Marc Miravitlles
Borja G. Cosío
Aurelio Arnedillo
Myriam Calle
Bernardino Alcázar-Navarrete
Cruz González
Cristóbal Esteban
Juan Antonio Trigueros
José Miguel Rodríguez González-Moro
José Antonio Quintano Jiménez
Adolfo Baloira
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2017
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-017-0682-y

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