Document Detail

Tailoring of corticosteroids in COPD management.
MedLine Citation:
PMID:  25089228     Owner:  NLM     Status:  Publisher    
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.
Daan A De Coster; Melvyn Jones
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Publication Detail:
Type:  REVIEW     Date:  2014-7-6
Journal Detail:
Title:  Current respiratory care reports     Volume:  3     ISSN:  2161-332X     ISO Abbreviation:  Curr Respir Care Rep     Publication Date:  2014  
Date Detail:
Created Date:  2014-8-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101587973     Medline TA:  Curr Respir Care Rep     Country:  -    
Other Details:
Languages:  ENG     Pagination:  121-132     Citation Subset:  -    
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