SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2021
Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD.
Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 8 syntheses or guidelines pooled it, 148 citations in OpenAlex.
- Comparative effectiveness of triple versus dual inhaled therapy (ICS/LABA or LABA/LAMA) for chronic obstructive pulmonary disease: a systematic review and network meta-analysis.BMC pulmonary medicine · 2026Pooled it
- Glucocorticoid treatment and new-onset hyperglycaemia and diabetes in people living with chronic obstructive pulmonary disease: A systematic review and meta-analysis.Diabetic medicine : a journal of the British Diabetic Association · 2025Pooled it
- Evaluating inhaled corticosteroids' impact on osteoporosis and fracture risk in COPD patients: a real-world evidence-based systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Efficacy and safety of oral proprietary Chinese medicines in the treatment of stable chronic obstructive pulmonary disease: a network meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Effect of fracture risk in inhaled corticosteroids in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.BMC pulmonary medicine · 2023Pooled it
- The association between inhaled corticosteroid and the risks of SARS-COV-2 infection: A systematic review and meta-analysis.Journal of infection and public health · 2023Pooled it
- Inhaled corticosteroids versus placebo for stable chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2023Pooled it
- Physio-metabolic and clinical consequences of wearing face masks-Systematic review with meta-analysis and comprehensive evaluation.Frontiers in public health · 2023Pooled it
- Phase 2a randomised, double-blind, placebo-controlled study to evaluate the efficacy and safety of londamocitinib (AZD4604) two times per day for 12 weeks in adult patients with moderate-to-severe asthma uncontrolled on medium-high-dose ICS-LABA.BMJ open respiratory research · 2026Trial
- Trial
- Expression of HDAC2 and HDAC8 in the airways of COPD patients is associated with responsiveness to ICS: insights from the HISTORIC study.The European respiratory journal · 2026Article
- Updates in COPD Management: From Inflammatory Pathways to Targeted Therapies.European journal of clinical investigation · 2026Review
- Observational
- Article
- Integrated network pharmacology, molecular docking, and experimental validation to reveal the potential mechanism of Ginsenoside Rg1 on chronic obstructive pulmonary disease.Scientific reports · 2026Article
- Comparative Real-World Effectiveness of Fixed-Dose Triple Therapy Regimens in COPD: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Metagenomic Next-Generation Sequencing for Pulmonary Tuberculosis Diagnosis and Infection Risk Factor Analysis in AECOPD Patients: A Single-Center Retrospective Study.Journal of clinical medicine · 2026Article
- Research progress of drug-induced osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Hyaluronic acid-based microgels loaded with fluticasone furoate for bleomycin-induced acute lung injury treatment.Materials today. Bio · 2025Article
- Neutrophil dysfunction in bronchiectasis: Pathophysiological insights and emerging targeted therapies.Multidisciplinary respiratory medicine · 2025Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inhaled corticosteroids (ICSs) are indicated for the prevention of exacerbations in COPD; however, a significant proportion of patients at low risk of exacerbations are treated with ICSs. We conducted a systematic review including a diversity of types of study designs and safety outcomes with the objective of describing the risk of adverse effects associated with the long-term use of ICSs in patients with COPD.A total of 90 references corresponding to 83 studies were included, including 26 randomised clinical trials (RCTs), 33 cohort studies, and 24 nested case-control (NCC) studies. Analysis of 19 RCTs showed that exposure to ICSs for ≥1 year increased the risk of pneumonia by 41% (risk ratio 1.41, 95% CI 1.23-1.61). Additionally, cohort and NCC studies showed an association between ICSs and risk of tuberculosis and mycobacterial disease. There was a strong association between ICS use and local disorders such as oral candidiasis and dysphonia. The association between ICSs and the risk of diabetes and fractures was less clear and appeared significant only at high doses of ICSs.Since most patients with COPD are elderly and with frequent comorbidities, an adequate risk-benefit balance is crucial for the indication of ICSs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.