title: Safety of inhaled corticosteroids for treating chronic obstructive pulmonary disease.
abstract: BACKGROUND
  The frequent use of inhaled corticosteroids (ICSs), especially at higher doses, has been accompanied by concern about both systemic and local side effects. Patients suffering from chronic obstructive pulmonary disease (COPD) are more at risk from side effects, likely because of the use of higher doses of ICS in COPD to overcome corticosteroid unresponsiveness.
  
  
  METHODS
  There is considerable concern about increased incidence of pneumonia, osteoporosis and hyperglycemia in diabetic patients and cataracts. The local side effects of ICSs, such as hoarseness and pharyngeal discomfort, oral and oropharyngeal candidiasis, cough during inhalation, and a sensation of thirst, are not usually serious but are of clinical importance because they may lead to patients discontinuing therapy.
  
  
  CONCLUSIONS
  The possibility that ICSs induce adverse side effects should not lead us to avoid their use in patients in whom clinical evidence suggests that they may be helpful. However, clinicians should balance the potential benefits of ICSs in COPD against their potential side effects and always consider using the lowest possible dose to achieve the best possible management.
authors.affiliation: Second University of Naples, Department of Experimental Medicine , Via del Parco Margherita 24, Naples 80121 , Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Matera
authors.forename: Vittorio
authors.initials: V
authors.lastname: Cardaci
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
authors.forename: Paola
authors.initials: P
authors.lastname: Rogliani
mesh_terms: D000280:Administration, Inhalation; D004305:Dose-Response Relationship, Drug; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: chronic obstructive pulmonary disease; diabetes mellitus; inhaled corticosteroids; local side effects; osteoporosis; pneumonia; systemic side effects.