TY - JOUR T1 - “Correct Use of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease”: A Consensus Document JO - Archivos de Bronconeumología T2 - AU - Alcázar Navarrete,Bernardino AU - Casanova,Ciro AU - Miravitlles,Marc AU - de Lucas,Pilar AU - Riesco,Juan Antonio AU - Rodríguez González-Moro,José Miguel SN - 15792129 M3 - 10.1016/j.arbr.2015.02.002 DO - 10.1016/j.arbr.2015.02.002 UR - https://archbronconeumol.org/en-correct-use-inhaled-corticosteroids-in-articulo-S1579212915000208 AB - IntroductionIndications for inhaled corticosteroids (IC) in combination with long-acting bronchodilators (LABD) are well defined in clinical practice guidelines. However, there are some doubts about their efficacy and safety. The aim of this document is to establish an expert consensus to clarify these issues. MethodA coordinator group was formed, which systematically reviewed the scientific evidence with the aim of identifying areas of uncertainty about the efficacy of ICs, the adverse effects associated with their use and criteria for withdrawal. Their proposals were submitted to a panel of experts and the Delphi technique was used to test the level of consensus. ResultsTwenty-five experts participated in the panel, and consensus was reached on the use of IC in the mixed chronic obstructive pulmonary disease (COPD)-asthma phenotype and in frequent exacerbators, and on not using IC in association with LABD for improving lung function in COPD. There was no general consensus on restricting the use of IC to prevent adverse effects. The panel did agree that IC withdrawal is feasible but should be undertaken gradually, and patients who have discontinued must be evaluated in the short term. ConclusionsConsensus was reached regarding the indication of IC in mixed COPD-asthma and frequent exacerbator phenotypes. The potential for adverse effects must be taken into consideration, but there is no consensus on whether limiting use is justified. The withdrawal of ICs was uniformly agreed to be feasible. ER -