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oai:repisalud.isciii.es:20.500.12105/204642024-11-28T21:51:29Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967col_20.500.12105_16969col_20.500.12105_16984

00925njm 22002777a 4500 dc Miravitlles, Marc author García-Cosío, Borja author Arnedillo, Aurelio author Calle, Myriam author Alcazar-Navarrete, Bernardino author Gonzalez, Cruz author Esteban, Cristobal author Antonio Trigueros, Juan author Rodriguez Gonzalez-Moro, Jose Miguel author Quintano Jimenez, Jose Antonio author Baloira, Adolfo author 2017-11-28 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. Miravitlles M, Cosio BG, Arnedillo A, Calle M, Alcazar-Navarrete B, Gonzalez C, et al. A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease. Respir Res. 2017 Nov 28;18:198. 10.1186/s12931-017-0682-y 1465-993X Respiratory Research http://hdl.handle.net/20.500.13003/9555 29183382 L619448495 2-s2.0-85036572242 http://hdl.handle.net/20.500.12105/20464 416428100002 Algorithm Chronic obstructive pulmonary disease Exacerbations Inhaled corticosteroids Lung function A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease