title: [The place of inhaled corticosteroids in COPD].
abstract: BACKGROUND
  Clinical trials have provided some evidence of a favorable effect of inhaled corticosteroids on the frequency of exacerbations and on the quality of life of patients with chronic obstructive pulmonary disease (COPD). In contrast, ICS have little or no impact on lung function decline and on mortality.
  
  
  BACKGROUND
  Inhaled corticosteroids are recommended only in a minority of COPD patients, those with severe disease and repeated exacerbations and probably those with the COPD and asthma overlap syndrome. However, surveys indicate that these drugs are inappropriately prescribed in a large population of patients with COPD. Overtreatment with inhaled corticosteroids exposes these patients to an increased risk of potentially severe side-effects such as pneumonia, osteoporosis, and oropharyngeal candidiasis. Moreover, it represents a major waste of health-care spending.
  
  
  CONCLUSIONS
  Primary care physicians as well as pulmonologists should be better aware of the benefits as well as the side-effects and costs of inhaled corticosteroids.
authors.affiliation: Service de pneumologie et oncologie thoracique, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, université de Versailles SQY, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France. Electronic address: thierry.chinet@apr.aphp.fr.
authors.forename: T
authors.initials: T
authors.lastname: Chinet
authors.affiliation: Service de pneumologie et oncologie thoracique, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, université de Versailles SQY, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
authors.forename: J
authors.initials: J
authors.lastname: Dumoulin
authors.affiliation: Service de pneumologie, hôpital Cochin, 75679 Paris cedex 14, France.
authors.forename: I
authors.initials: I
authors.lastname: Honore
authors.affiliation: Service de pneumologie, hôpital Cochin, hôpitaux universitaires Paris-Centre, site Val-de-Grâce, 75005 Paris, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Braun
authors.affiliation: Service de pneumologie et UPRES EA 220 92150, hôpital Foch, Suresnes, France.
authors.forename: L-J
authors.initials: LJ
authors.lastname: Couderc
authors.affiliation: Service de pneumologie, hôpital Tenon, 75020 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Febvre
authors.affiliation: Service de pneumologie, CHIC de Créteil, 94000 Créteil, France.
authors.forename: G
authors.initials: G
authors.lastname: Mangiapan
authors.affiliation: Service de pneumologie, centre hospitalier Le Raincy-Montfermeil, 93370 Montfermeil, France.
authors.forename: C
authors.initials: C
authors.lastname: Maurer
authors.affiliation: Service de pneumologie, hôpital Cochin, 75679 Paris cedex 14, France.
authors.forename: P
authors.initials: P
authors.lastname: Serrier
authors.affiliation: Hôpital privé d'Antony, 92160 Antony, France.
authors.forename: F
authors.initials: F
authors.lastname: Soyez
authors.affiliation: Service de médecine interne, centre hospitalier de Coulommiers, 77120 Coulommiers, France.
authors.forename: P
authors.initials: P
authors.lastname: Terrioux
authors.affiliation: Service de pneumologie B et de transplantations pulmonaires, hôpital Bichat-Claude-Bernard, 75877 Paris cedex 18, France.
authors.forename: G
authors.initials: G
authors.lastname: Jebrak
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D001993:Bronchodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents
keywords: Adverse effects; BPCO; COPD; Corticostéroïdes inhalés; Iatrogénie; Inhaled corticosteroids