De Coster, DA;
Jones, M;
(2014)
Tailoring of corticosteroids in COPD management.
Current Respiratory Care Reports
, 3
(3)
121 - 132.
10.1007/s13665-014-0084-2.
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Abstract
This literature review updates the reader on the new studies regarding steroid therapy over the last year in stable COPD and in exacerbations. In stable COPD, we critique the 2011 update and 2013 revision of the GOLD guidelines, discuss why combining inhaled corticosteroids (ICS) with long-acting beta-agonists (LABA) (ICS/LABA) is preferable over LABA alone and review the literature for intraclass differences, finding that the evidence does not clearly support superiority of any particular ICS/LABA. We also address other comparisons against ICS/LABA, including triple therapy. We briefly review which type of inhaler should be chosen. For exacerbations, we report the REDUCE trial findings favouring a 5-day course of systemic steroids, and other trials addressing which steroid and route to use, including in an intensive care setting. Lastly, the future lies in new anti-inflammatories and re-phenotyping the heterogeneous amalgamation of COPD. A Spanish guideline recommends distinguishing steroid-responsive eosinophilic exacerbators from other phenotypes.
| Type: | Article |
|---|---|
| Title: | Tailoring of corticosteroids in COPD management |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s13665-014-0084-2 |
| Publisher version: | http://dx.doi.org/10.1007/s13665-014-0084-2 |
| Additional information: | © The Author(s) 2014. This article is published with open access at Springerlink.com. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
| Keywords: | Corticosteroids COPD Drug therapy Fluticasone Budesonide Beclometasone Ciclesonide Mometasone Salmeterol Formoterol Vilanterol Tiotropium Glycopyrronium Inhaler MDI DPI Phenotype Heterogeneity Withdrawal Exacerbation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1437474 |
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