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oai:repisalud.isciii.es:20.500.12105/226262024-11-29T02:30:05Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc Luis Izquierdo, Jose author García-Cosío, Borja author 2018 Background: The use of inhaled corticosteroids (ICS) in combination with bronchodilators in patients with COPD has been shown to decrease the rate of disease exacerbations and to improve the lung function and patients' quality of life. However, their use has also been associated with an increased risk of pneumonia. Materials and methods: We have reviewed existing clinical evidence on the risks and benefits of ICS in COPD, including large randomized clinical trials, meta-analyses, and clinical reviews. Results: A large body of evidence supports the clinical benefits of ICS in patients with COPD in terms of exacerbations, symptoms, lung function, and quality of life. The incidence of adverse events related to ICS, including pneumonia, varies strongly among the studies and seems to be dose dependent, with recent well-designed, large studies on low-dose ICS reporting similar safety profiles in ICS and non-ICS groups. Conclusion: The benefits of ICS in COPD continue to outweigh the risks, especially when lower ICS doses are employed. Given that the data on ICS withdrawal in COPD are scarce and conflicting, we argue that using reduced doses of ICS could be an optimal strategy to manage patients with COPD. Izquierdo JL, Cosio BG. The dose of inhaled corticosteroids in patients with COPD: when less is better. Int J Chronic Obstr Pulm Dis. 2018;13:3539-47. 10.2147/COPD.S175047 1178-2005 International Journal of Chronic Obstructive Pulmonary Disease http://hdl.handle.net/20.500.13003/17166 30498343 L2001618402 2-s2.0-85057560531 https://hdl.handle.net/20.500.12105/22626 448301700001 Acute exacerbations Anti-inflammatory effects COPD Asthma-COPD overlap syndrome Inhaled corticosteroids lOwer doses of ICS Pneumonia The dose of inhaled corticosteroids in patients with COPD: when less is better