مراجعة
A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease
| العنوان: | A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease |
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| المؤلفون: | Miravitlles, Marc, Cosio, Borja G., Arnedillo, Aurelio, Calle, Myriam, Alcazar-Navarrete, Bernardino, Gonzalez, Cruz, Esteban, Cristobal, Antonio Trigueros, Juan, Rodriguez Gonzalez-Moro, Jose Miguel, Quintano Jimenez, Jose Antonio, Baloira, Adolfo |
| المساهمون: | Miravitlles, Marc Hosp Univ Vall dHebron, Pneumol Dept, P Vall dHebron 119-129, Barcelona 08035, Spain, Cosio, Borja G. CIBER Enfermedades Resp CIBERES, Barcelona, Spain, Cosio, Borja G. Hosp Univ Son Espases IdISBa, Dept Resp Med, Palma De Mallorca, Spain, Arnedillo, Aurelio Hosp Univ Puerta Mar, Pneumol Allergy & Thorac Surg Dept, Cadiz, Spain, Arnedillo, Aurelio Univ Cadiz, Med Dept, Cadiz, Spain, Calle, Myriam Hosp Clin San Carlos, Inst Invest Sanitaria Hosp Clin San Car Carlos Id, Pulm Dept, Madrid, Spain, Calle, Myriam Univ Complutense Madrid, Fac Med, Dept Med, Madrid, Spain, Alcazar-Navarrete, Bernardino Agencia Sanitaria Hosp Poniente, Hosp Alta Resoluc Loja, Resp Dept, AIG Med, Granada, Spain, Gonzalez, Cruz Hosp Clin Univ, Dept Resp Med, Valencia, Spain, Gonzalez, Cruz Inst Invest Sanitaria INCLIVA Valencia, Valencia, Spain, Esteban, Cristobal Hosp Galdakao Usansolo, Pneumol Dept, Biscay, Spain, Esteban, Cristobal Red Invest Serv Sanitarios & Enfermed Cron REDISS, Bilbao, Spain, Antonio Trigueros, Juan Auton Hlth Serv, Hlth Ctr Menasalbas, Toledo, Spain, Rodriguez Gonzalez-Moro, Jose Miguel Hosp Univ Principe Asturias, Pneumol Dept, Madrid, Spain, Quintano Jimenez, Jose Antonio Ctr Salud Lucena I, Cordoba, Spain, Baloira, Adolfo Complejo Hosp Univ Pontevedra, Serv Neurol, Pontevedra, Spain, Novartis |
| بيانات النشر: | Bmc |
| سنة النشر: | 2017 |
| المجموعة: | Sistema Sanitario Público de Andalucía (SSPA): Repositorio |
| مصطلحات موضوعية: | Algorithm, Chronic obstructive pulmonary disease, Exacerbations, Inhaled corticosteroids, Lung function, Copd overlap syndrome, Fluticasone propionate, Blood eosinophils, Salmeterol/fluticasone propionate, Double-blind, Salmeterol-fluticasone, Risk, Management, Asthma |
| الوصف: | 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. |
| نوع الوثيقة: | review |
| اللغة: | English |
| تدمد: | 1465-993X |
| العلاقة: | http://hdl.handle.net/10668/19127Test; https://doi.org/10.1186/s12931-017-0682-yTest; 416428100002 |
| DOI: | 10.1186/s12931-017-0682-y |
| الإتاحة: | https://doi.org/10.1186/s12931-017-0682-yTest http://hdl.handle.net/10668/19127Test |
| حقوق: | Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0Test/ ; open access |
| رقم الانضمام: | edsbas.1CF70CAE |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 1465993X |
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| DOI: | 10.1186/s12931-017-0682-y |