Overuse of inhaled corticosteroids in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease: Observational real-life data.

Advances in the understanding of chronic obstructive pulmonary disease (COPD) pathophysiology have prompted continual updates in therapeutic strategies. The role of inhaled corticosteroids (ICS) in COPD treatment has changed over time. This study aimed to identify the high rates of inappropriate use of ICS-containing treatment regimens in daily clinical practice, contrary to guideline recommendations, and to demonstrate the negative consequences of this misuse. Patients who received inpatient treatment for COPD exacerbation were included in this study. The investigation focused on maintenance therapies, ICS use, COPD severity levels, exacerbation severity, and causes of the exacerbations. The relationship between ICS use, doses of ICS used, exacerbation severity, and infection was analyzed. This study analyzed the ICS use status of 233 patients. Of these, 205 patients were using ICS, and 28 were not. A significant correlation was found between total corticosteroid dose and exacerbation severity. High-dose ICS use was significantly higher in patients with infection as the cause of the exacerbation. When evaluating patients' eosinophil counts and treatment regimens, ICS treatment was found to be prescribed more frequently than recommended. The role of ICS therapy in COPD treatment is clearly stated in the current guidelines. This study, based on real-life data, found a high rate of off-label ICS use that was inconsistent with guideline recommendations. Inappropriate ICS use did not provide additional benefits in treatment management and had negative effects on patients, including significant side effects, such as infection. Clinicians should exercise caution when adding an ICS-containing regimen to their prescriptions.