Overuse of inhaled corticosteroids in COPD: five questions for withdrawal in daily practice.

Autor: Cataldo D; Department of Respiratory Medicine, Centre Hospitalier Universitaire de Liège (CHU) and University of Liège, Liège, Belgium, didier.cataldo@uliege.be., Derom E; Department of Respiratory Medicine, Ghent University Hospital, Gent, Belgium., Liistro G; Department of Respiratory Medicine, University Hospitals Saint-Luc, Brussels, Belgium., Marchand E; Department of Respiratory Medicine, University Hospital UCL Namur, Yvoir, Belgium.; URPhyM, University of Namur, Namur, Belgium., Ninane V; Department of Respiratory Medicine, University Hospital Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium., Peché R; Department of Respiratory Medicine, University Hospital Vésale, Montigny-le-Tilleul, Belgium., Slabbynck H; Department of Respiratory Medicine, ZNA Middelheim, Antwerpen, Belgium., Vincken W; Respiratory Division, University Hospital Brussels (UZ Brussel), Vrije Universiteit Brussel, Brussels, Belgium., Janssens W; Department of Respiratory Medicine, University Hospitals Leuven, Leuven, Belgium.
Jazyk: angličtina
Zdroj: International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2018 Jul 05; Vol. 13, pp. 2089-2099. Date of Electronic Publication: 2018 Jul 05 (Print Publication: 2018).
DOI: 10.2147/COPD.S164259
Abstrakt: Evidence and guidelines are becoming increasingly clear about imbalance between the risks and benefits of inhaled corticosteroids (ICSs) in patients with COPD. While selected patients may benefit from ICS-containing regimens, ICSs are often inappropriately prescribed with - according to Belgian market research data - up to 70% of patients in current practice receiving ICSs, usually as a fixed combination with a long-acting β 2 -adrenoreceptor agonist. Studies and recommendations support withdrawal of ICSs in a large group of patients with COPD. However, historical habits appear difficult to change even in the light of recent scientific evidence. We have built a collaborative educational platform with chest physicians and primary care physicians to increase awareness and provide guidance and support in this matter.
Competing Interests: Disclosure DC is the founder of Aquilon Pharmaceuticals and had received speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis, Mundipharma, Chiesi, and GlaxoSmithKline (GSK) and consultancy fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK and Novartis for the participation to advisory boards. ED’s clinical department received financial support from Boehringer Ingelheim and Novartis to perform clinical studies. He participated in advisory boards by Boehringer Ingelheim, Chiesi, Cipla, Novartis, and AstraZeneca, for which a fee was given to the clinical department. He received travel grants from Boehringer Ingelheim, GSK, and AstraZeneca to attend international congresses. He also received speaker fees from Boehringer Ingelheim, GSK, AstraZeneca, and Novartis to give scientific presentations to local GP groupings for which a fee was given to the clinical department. GL received speaker fees from Boehringer Ingelheim, Novartis, and Chiesi and consultancy fees from AstraZeneca, Boehringer Ingelheim, Chiesi, and Novartis for the participation to advisory boards. EM received speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, and Novartis and consultancy fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, and Novartis for the participation to advisory boards. VN received speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis, and Bristol-Myers Squibb and consultancy fees from AstraZeneca, Boehringer Ingelheim, Novartis, Bristol-Myers Squibb, and GSK for the participation to advisory boards. RP received speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis, Chiesi, and GSK and consultancy fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, and Novartis for the participation to advisory boards. HS received speaker fees from AstraZeneca, Boehringer Ingelheim, and Roche and consultancy fees from Boehringer Ingelheim, GSK, and Roche for the participation to advisory boards. WV has been a member of advisory boards of and/or has been a speaker for AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, and Novartis. WJ is a senior clinical researcher of the FWO. He is a chair holder of the Belgian AstraZeneca Chair for Respiratory Pathophysiology. He received research grants and consultancy fees from Boehringer Ingelheim, AstraZeneca, Novartis, Chiesi, and GSK. The authors report no other conflicts of interest in this work.
Databáze: MEDLINE
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