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Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart

The use of inhaled corticosteroids (ICS) for the maintenance of bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD) is controversial. While some patients achieve clinical benefits, such as fewer exacerbations and improved symptoms, others do not, and some experienc...

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Autores principales: Oishi, Keiji, Matsunaga, Kazuto, Yamamoto, Tasuku, Matsuda, Kazuki, Murata, Yoriyuki, Hirano, Tsunahiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953425/
https://www.ncbi.nlm.nih.gov/pubmed/36830583
http://dx.doi.org/10.3390/biom13020213
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author Oishi, Keiji
Matsunaga, Kazuto
Yamamoto, Tasuku
Matsuda, Kazuki
Murata, Yoriyuki
Hirano, Tsunahiko
author_facet Oishi, Keiji
Matsunaga, Kazuto
Yamamoto, Tasuku
Matsuda, Kazuki
Murata, Yoriyuki
Hirano, Tsunahiko
author_sort Oishi, Keiji
collection PubMed
description The use of inhaled corticosteroids (ICS) for the maintenance of bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD) is controversial. While some patients achieve clinical benefits, such as fewer exacerbations and improved symptoms, others do not, and some experience undesired side effects, such as pneumonia. Thus, we reviewed the evidence related to predictors of ICS therapy treatment response in patients with COPD. The first priority clinical markers when considering the efficacy of ICS are type 2 inflammatory biomarkers, followed by a history of suspected asthma and recurrent exacerbations. It is also necessary to consider any potential infection risk associated with ICS, and several risk factors for pneumonia when using ICS have been clarified in recent years. In this article, based on the evidence supporting the selection of ICS for COPD, we propose an ICS composite that can be added to the COPD (ICO) chart for use in clinical practice. The chart divided the type 2 biomarkers into three ranges and provided recommendations (recommend, consider, and against) by combining the history of suspected asthma, history of exacerbations, and risk of infection.
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spelling pubmed-99534252023-02-25 Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart Oishi, Keiji Matsunaga, Kazuto Yamamoto, Tasuku Matsuda, Kazuki Murata, Yoriyuki Hirano, Tsunahiko Biomolecules Review The use of inhaled corticosteroids (ICS) for the maintenance of bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD) is controversial. While some patients achieve clinical benefits, such as fewer exacerbations and improved symptoms, others do not, and some experience undesired side effects, such as pneumonia. Thus, we reviewed the evidence related to predictors of ICS therapy treatment response in patients with COPD. The first priority clinical markers when considering the efficacy of ICS are type 2 inflammatory biomarkers, followed by a history of suspected asthma and recurrent exacerbations. It is also necessary to consider any potential infection risk associated with ICS, and several risk factors for pneumonia when using ICS have been clarified in recent years. In this article, based on the evidence supporting the selection of ICS for COPD, we propose an ICS composite that can be added to the COPD (ICO) chart for use in clinical practice. The chart divided the type 2 biomarkers into three ranges and provided recommendations (recommend, consider, and against) by combining the history of suspected asthma, history of exacerbations, and risk of infection. MDPI 2023-01-22 /pmc/articles/PMC9953425/ /pubmed/36830583 http://dx.doi.org/10.3390/biom13020213 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Oishi, Keiji
Matsunaga, Kazuto
Yamamoto, Tasuku
Matsuda, Kazuki
Murata, Yoriyuki
Hirano, Tsunahiko
Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart
title Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart
title_full Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart
title_fullStr Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart
title_full_unstemmed Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart
title_short Practical Recommendations for a Selection of Inhaled Corticosteroids in COPD: A Composite ICO Chart
title_sort practical recommendations for a selection of inhaled corticosteroids in copd: a composite ico chart
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953425/
https://www.ncbi.nlm.nih.gov/pubmed/36830583
http://dx.doi.org/10.3390/biom13020213
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