What are the benefits and risks of inhaled corticosteroids for COPD?
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Q: What are the benefits and risks of inhaled corticosteroids for COPD? A: Inhaled corticosteroids (ICS), either alone or with a long-acting [beta] agonist (LABA), reduce the frequency of exacerbations of chronic obstructive pulmonary disease (COPD) and statistically, but not clinically, improve quality of life (QOL) (strength of recommendation [SOR]: B, meta-analyses of heterogeneous studies). However, ICS have no mortality benefit and don’t consistently improve forced expiratory volume in 1 second (FEV1) (SOR: B, meta-analyses of secondary outcomes). They increase the risk of pneumonia, oropharyngeal candidiasis, and bruising (SOR: B, meta-analyses of secondary outcomes). Withdrawal of ICS doesn’t significantly increase the risk of COPD exacerbation (SOR: B, a meta-analysis).
Journal of Family Practice, 63(5) 2014: 276-278