ReviewNPJ primary care respiratory medicine2023
Rational use of inhaled corticosteroids for the treatment of COPD.
Review in NPJ primary care respiratory medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis 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
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Intraclass comparison of inhaled corticosteroids for the risk of pneumonia in chronic obstructive pulmonary airway disorder: a network meta-analysis and meta-regression.International journal of clinical pharmacy · 2024Pooled it
- Benefits of budesonide/glycopyrronium/formoterol fumarate dihydrate on lung function and exacerbations of COPD: a post-hoc analysis of the KRONOS study by blood eosinophil level and exacerbation history.Respiratory research · 2024Trial
- Post-Tuberculosis Lung Disease: Clinicopathologic Insights, Diagnosis, Prevention, and Management.MedComm · 2026Review
- Observational
- Comparative Real-World Effectiveness of Fixed-Dose Triple Therapy Regimens in COPD: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- The high-risk B-to-E transitional phenotype: a prospective multi-centre validation of patient reclassification under the updated GOLD 2026 criteria.Journal of global health · 2026Article
- Corticosteroids in asthma and COPD: an inflammopharmacological perspective on molecular and genetic determinants.Molecular biology reports · 2026Review
- SM17, an anti-interleukin-17 receptor B antibody, ameliorates pathogenesis of chronic rhinosinusitis with nasal polyps and idiopathic pulmonary fibrosisERJ open research · 2026Article
- Inhaled corticosteroid overuse and deprescribing eligibility in COPD (iCODEC Study): a nationwide cross-sectional analysis in China.NPJ primary care respiratory medicine · 2026Article
- Unknotting the crosstalk between COPD and neuroinflammation.Journal of neuroinflammation · 2026Review
- Persistently low blood eosinophils identify a high-risk phenotype in COPD.BMC pulmonary medicine · 2026Article
- Inhalation-Based Nanoparticle Drug Delivery Targeting the Diseased Lower Airways in Idiopathic Pulmonary Fibrosis.Pharmaceutics · 2026Review
- Changes in device-matched peak inspiratory flow after bedside inhaler coaching and factors associated with residual suboptimal flow: a retrospective observational study.Frontiers in pharmacology · 2026Article
- Inhaled Corticosteroid Use and Self-Reported Voice Problems in a Nordic Population-Based Cohort.Journal of asthma and allergy · 2026Article
- Chronic Obstructive Pulmonary Disease (COPD): Developments in Pharmacological Treatments.Drugs · 2025Review
- An unconventional T cell nexus drives HCK-mediated chronic obstructive pulmonary disease in mice.EBioMedicine · 2025Article
- Advances in Therapeutics for Chronic Lung Diseases: From Standard Therapies to Emerging Breakthroughs.Journal of clinical medicine · 2025Review
- Emerging trends and hotspots in chronic obstructive pulmonary disease and oxidative stress: a bibliometric and visualized analysis from 2010 to 2024.Journal of thoracic disease · 2025Article
- Adherence to Inhaled Medication Guidelines in Patients with COPD: Evaluating the GOLD 2023 Strategy in a Real-World Secondary Care Setting.International journal of chronic obstructive pulmonary disease · 2025Article
- Impact of Airway-Occluding Mucus Plugs on Mortality in Patients with COPD According to Disease Severity: A Subset Analysis of Data From COPDGene.International journal of chronic obstructive pulmonary disease · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inhaled corticosteroids (ICS) are the mainstay of treatment for asthma, but their role in chronic obstructive pulmonary disease (COPD) is debated. Recent randomised controlled trials (RCTs) conducted in patients with COPD and frequent or severe exacerbations demonstrated a significant reduction (~25%) in exacerbations with ICS in combination with dual bronchodilator therapy (triple therapy). However, the suggestion of a mortality benefit associated with ICS in these trials has since been rejected by the European Medicines Agency and US Food and Drug Administration. Observational evidence from routine clinical practice demonstrates that dual bronchodilation is associated with better clinical outcomes than triple therapy in a broad population of patients with COPD and infrequent exacerbations. This reinforces guideline recommendations that ICS-containing maintenance therapy should be reserved for patients with frequent or severe exacerbations and high blood eosinophils (~10% of the COPD population), or those with concomitant asthma. However, data from routine clinical practice indicate ICS overuse, with up to 50-80% of patients prescribed ICS. Prescription of ICS in patients not fulfilling guideline criteria puts patients at unnecessary risk of pneumonia and other long-term adverse events and also has cost implications, without any clear benefit in disease control. In this article, we review the benefits and risks of ICS use in COPD, drawing on evidence from RCTs and observational studies conducted in primary care. We also provide a practical guide to prescribing ICS, based on the latest global treatment guidelines, to help primary care providers identify patients for whom the benefits of ICS outweigh the risks.
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.