title: Use of inhaled corticosteroids in COPD: improving efficacy.
abstract: Chronic obstructive pulmonary disease (COPD) is a chronic, inflammatory lung disease characterized by airflow limitation that is not fully reversible. The pathological changes in COPD lead to alveolar destruction (emphysema) and chronic airway inflammation, resulting in airflow obstruction and recurrent exacerbations. Inhaled corticosteroids (ICS) are anti-inflammatory agents that are widely used, especially in combination with long-acting beta-agonists, in patients with COPD. Here, we will summarize the benefits and risks of ICS use for COPD, and discuss approaches to more personalized medicine when selecting COPD patients to commence (or withdraw) ICS use. The conclusion arising is that further validation of clinical and biological markers should be undertaken in COPD, in order to individualize ICS therapy to maximize efficacy for patients.
authors: a Department of Thoracic Medicine , The Prince Charles Hospital, Metro North Hospital and Health Service , Brisbane , Australia.|b School of Medicine , The University of Queensland , Brisbane , Australia.
authors: Ian A
authors: IA
authors: Yang
authors: a Department of Thoracic Medicine , The Prince Charles Hospital, Metro North Hospital and Health Service , Brisbane , Australia.|b School of Medicine , The University of Queensland , Brisbane , Australia.
authors: Janet G
authors: JG
authors: Shaw
authors: a Department of Thoracic Medicine , The Prince Charles Hospital, Metro North Hospital and Health Service , Brisbane , Australia.|b School of Medicine , The University of Queensland , Brisbane , Australia.
authors: John R
authors: JR
authors: Goddard
authors: b School of Medicine , The University of Queensland , Brisbane , Australia.|c Department of Endocrinology , Royal Brisbane and Women's Hospital , Brisbane , Australia.
authors: Melissa S
authors: MS
authors: Clarke
authors: a Department of Thoracic Medicine , The Prince Charles Hospital, Metro North Hospital and Health Service , Brisbane , Australia.|b School of Medicine , The University of Queensland , Brisbane , Australia.|d Lung Infection and Inflammation Laboratory , QIMR Berghofer Medical Research Institute , Brisbane , Australia.
authors: David W
authors: DW
authors: Reid
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D018579:Patient Selection; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents
keywords: Corticosteroids; adverse effects; biomarkers; chronic obstructive pulmonary disease; inhaled; treatment