title: Inhaled corticosteroids in chronic obstructive pulmonary disease: a pro-con perspective.
abstract: Current guidelines limit regular use of inhaled corticosteroids (ICS) to a specific subgroup of patients with chronic obstructive pulmonary disease (COPD) in whom the forced expiratory volume in 1 s is <60% of predicted and who have frequent exacerbations. In these patients, there is evidence that ICS reduce the frequency of exacerbations and improve lung function and quality of life. However, a review of the literature suggests that the evidence available may be interpreted to favour or contradict these observations. It becomes apparent that COPD is a heterogeneous condition. Clinicians therefore need to be aware of the heterogeneity as well as having an understanding of how ICS may be used in the context of the specific subgroups of patients with COPD. This review argues for and against the use of ICS in COPD by providing an in-depth analysis of the currently available evidence.
authors.affiliation: Department of Respiratory Medicine, Queen Alexandra Hospital, Cosham, Portsmouth, Hampshire, UK.
authors.forename: K Suresh
authors.initials: KS
authors.lastname: Babu
authors.forename: Jack A
authors.initials: JA
authors.lastname: Kastelik
authors.forename: Jaymin B
authors.initials: JB
authors.lastname: Morjaria
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D011788:Quality of Life; D012129:Respiratory Function Tests; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents
keywords: adverse events; budesonide/formoterol; fluticasone/salmeterol; inhaled corticosteroids; mortality; pneumonia
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