Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease: Benefits and Risks

Clin Chest Med. 2020 Sep;41(3):475-484. doi: 10.1016/j.ccm.2020.05.006.

Abstract

Inhaled corticosteroids (ICSs), when used in combination with long-acting bronchodilators, reduce the risk of exacerbations and improve health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with bronchodilator or ICS therapy alone. Potential side effects of ICSs include adverse effects on glycemic control, bone density, cataract formation, skin changes, oral candidiasis, and pulmonary infections. Pneumonia is observed at increased rates in COPD patients, in particular those with greater airflow limitation, low body mass index, advanced age, and male gender, and ICSs may increase this risk. Risk assessment is essential in selecting appropriate patients for ICS-containing therapy.

Keywords: COPD; Exacerbations; Inhaled corticosteroids; Pneumonia.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / pharmacology
  • Adrenal Cortex Hormones / therapeutic use*
  • Bronchodilator Agents / pharmacology
  • Bronchodilator Agents / therapeutic use*
  • Drug Therapy, Combination / methods*
  • Humans
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Quality of Life / psychology*
  • Risk Assessment

Substances

  • Adrenal Cortex Hormones
  • Bronchodilator Agents