Inhaled Corticosteroids in COPD: Personalising the Therapeutic Choice

Overview

Journal Afr J Thorac Crit Care Med

Date 2021 Sep 20

PMID 34541493

Citations 2

Authors

J A Shaw

E M Irusen

Affiliations

Soon will be listed here.

Abstract

There has been a recent surge in interest in the role of inhaled corticosteroids (ICS) in the treatment of COPD, especially regarding patients with high eosinophil counts. Evidence has shown that despite the increase in localised adverse effects and a small increase in non-fatal pneumonia events with ICS use, ICS still have an important role to play in reducing exacerbation rates and addressing the inflammation that is at the heart of the pathogenesis of COPD. Current international guidelines recommend the use of ICS only in patients with severe disease. This review examines the potential role of ICS in all COPD patients.

Citing Articles

Pharmacotherapy of chronic obstructive pulmonary disease: Therapeutic considerations with a focus on inhaled corticosteroids.

Irusen E, Malange T S Afr Fam Pract (2004). 2020; 62(1):e1-e6.

PMID: 33314947 PMC: 8378153. DOI: 10.4102/safp.v62i1.5198.

Management of chronic obstructive pulmonary disease-A position statement of the South African Thoracic Society: 2019 update.

Abdool-Gaffar M, Calligaro G, Wong M, Smith C, Lalloo U, Koegelenberg C J Thorac Dis. 2020; 11(11):4408-4427.

PMID: 31903229 PMC: 6940223. DOI: 10.21037/jtd.2019.10.65.

References

Barnes P, Shapiro S, Pauwels R . Chronic obstructive pulmonary disease: molecular and cellular mechanisms. Eur Respir J. 2003; 22(4):672-88. DOI: 10.1183/09031936.03.00040703. View

Wedzicha J, Calverley P, Seemungal T, Hagan G, Ansari Z, Stockley R . The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol/fluticasone propionate or tiotropium bromide. Am J Respir Crit Care Med. 2007; 177(1):19-26. DOI: 10.1164/rccm.200707-973OC. View

Iannella H, Luna C, Waterer G . Inhaled corticosteroids and the increased risk of pneumonia: what's new? A 2015 updated review. Ther Adv Respir Dis. 2016; 10(3):235-55. PMC: 5933605. DOI: 10.1177/1753465816630208. View

Tashkin D, Rennard S, Martin P, Ramachandran S, Martin U, Silkoff P . Efficacy and safety of budesonide and formoterol in one pressurized metered-dose inhaler in patients with moderate to very severe chronic obstructive pulmonary disease: results of a 6-month randomized clinical trial. Drugs. 2008; 68(14):1975-2000. DOI: 10.2165/00003495-200868140-00004. View

Kew K, Seniukovich A . Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2014; (3):CD010115. PMC: 8966042. DOI: 10.1002/14651858.CD010115.pub2. View

Wang X, Nelson A, Weiler Z, Patil A, Sato T, Kanaji N . Anti-inflammatory effects of budesonide in human lung fibroblast are independent of histone deacetylase 2. J Inflamm Res. 2013; 6:109-19. PMC: 3780291. DOI: 10.2147/JIR.S43736. View

Sin D, McAlister F, Paul Man S, Anthonisen N . Contemporary management of chronic obstructive pulmonary disease: scientific review. JAMA. 2003; 290(17):2301-12. DOI: 10.1001/jama.290.17.2301. View

Tan D, White C, Walters J, Walters E . Inhaled corticosteroids with combination inhaled long-acting beta-agonists and long-acting muscarinic antagonists for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016; 11:CD011600. PMC: 6464947. DOI: 10.1002/14651858.CD011600.pub2. View

Wang C, Lai C, Yang W, Lin C, Chen L, Wang H . The association between inhaled corticosteroid and pneumonia in COPD patients: the improvement of patients' life quality with COPD in Taiwan (IMPACT) study. Int J Chron Obstruct Pulmon Dis. 2016; 11:2775-2783. PMC: 5108503. DOI: 10.2147/COPD.S116750. View

10.

Bathoorn E, Liesker J, Postma D, Boorsma M, Bondesson E, Koeter G . Anti-inflammatory effects of combined budesonide/formoterol in COPD exacerbations. COPD. 2008; 5(5):282-90. DOI: 10.1080/15412550802363360. View

11.

Hoonhorst S, Ten Hacken N, Vonk J, Timens W, Hiemstra P, Lapperre T . Steroid resistance in COPD? Overlap and differential anti-inflammatory effects in smokers and ex-smokers. PLoS One. 2014; 9(2):e87443. PMC: 3914834. DOI: 10.1371/journal.pone.0087443. View

12.

Chana K, Fenwick P, Nicholson A, Barnes P, Donnelly L . Identification of a distinct glucocorticosteroid-insensitive pulmonary macrophage phenotype in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2013; 133(1):207-16.e1-11. DOI: 10.1016/j.jaci.2013.08.044. View

13.

Barnes N, Qiu Y, Pavord I, Parker D, Davis P, Zhu J . Antiinflammatory effects of salmeterol/fluticasone propionate in chronic obstructive lung disease. Am J Respir Crit Care Med. 2006; 173(7):736-43. DOI: 10.1164/rccm.200508-1321OC. View

14.

Halpin D, Decramer M, Celli B, Kesten S, Liu D, Tashkin D . Exacerbation frequency and course of COPD. Int J Chron Obstruct Pulmon Dis. 2012; 7:653-61. PMC: 3459660. DOI: 10.2147/COPD.S34186. View

15.

Vestbo J, Edwards L, Scanlon P, Yates J, Agusti A, Bakke P . Changes in forced expiratory volume in 1 second over time in COPD. N Engl J Med. 2011; 365(13):1184-92. DOI: 10.1056/NEJMoa1105482. View

16.

Watz H, Tetzlaff K, Wouters E, Kirsten A, Magnussen H, Rodriguez-Roisin R . Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial. Lancet Respir Med. 2016; 4(5):390-8. DOI: 10.1016/S2213-2600(16)00100-4. View

17.

Tashkin D, Celli B, Senn S, Burkhart D, Kesten S, Menjoge S . A 4-year trial of tiotropium in chronic obstructive pulmonary disease. N Engl J Med. 2008; 359(15):1543-54. DOI: 10.1056/NEJMoa0805800. View

18.

Cascini S, Kirchmayer U, Belleudi V, Bauleo L, Pistelli R, Di Martino M . Inhaled Corticosteroid Use in Chronic Obstructive Pulmonary Disease and Risk of Pneumonia: A Nested Case-Control Population-based Study in Lazio (Italy)-The OUTPUL Study. COPD. 2017; 14(3):311-317. DOI: 10.1080/15412555.2016.1254172. View

19.

Jen R, Rennard S, Sin D . Effects of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2012; 7:587-95. PMC: 3459653. DOI: 10.2147/COPD.S32765. View

20.

Calzetta L, Matera M, Braido F, Contoli M, Corsico A, Di Marco F . Withdrawal of inhaled corticosteroids in COPD: A meta-analysis. Pulm Pharmacol Ther. 2017; 45:148-158. DOI: 10.1016/j.pupt.2017.06.002. View