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Perspectives

Applying the wisdom of stepping down inhaled corticosteroids in patients with COPD: a proposed algorithm for clinical practice

Pages 2535-2548 | Published online: 20 Nov 2015

Keep up to date with the latest research on this topic with citation updates for this article.

Read on this site (19)

Hongxia Duan, Long Liang, Xinyang Liu, Shuanshuan Xie & Changhui Wang. (2021) PARC/CCL18 is Associated with Inflammation, Emphysema Severity and Application of Inhaled Corticosteroids in Hospitalized COPD Patients. International Journal of Chronic Obstructive Pulmonary Disease 16, pages 1287-1297.
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Kjell Larsson, Ann Ekberg-Jansson, Caroline Stridsman, Malin Hanno & Lowie E G W Vanfleteren. (2021) Adherence to Treatment Recommendations for Chronic Obstructive Pulmonary Disease - Results from the Swedish National Airway Register. International Journal of Chronic Obstructive Pulmonary Disease 16, pages 909-918.
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Anne Orholm Nielsen, Ole Hilberg, Jens Ulrik Stæhr Jensen, Steffen Helmer Kristensen, Jannie Christina Frølund, Pernille Kølholt Langkilde & Anders Løkke. (2021) Withdrawal of Inhaled Corticosteroids in Patients with COPD – A Prospective Observational Study. International Journal of Chronic Obstructive Pulmonary Disease 16, pages 807-815.
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Joana Louise Marmy, Jens Peter Diedrich, Cordula Cadus, Peter Grendelmeier, Anne Tschacher, Thomas Dieterle, Prashant N. Chhajed & Jörg Daniel Leuppi. (2021) Adherence to GOLD Recommendations among Swiss Pulmonologists and General Practitioners. COPD: Journal of Chronic Obstructive Pulmonary Disease 18:1, pages 9-15.
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Paola Rogliani, Beatrice Ludovica Ritondo, Mariachiara Gabriele, Mario Cazzola & Luigino Calzetta. (2020) Optimizing de-escalation of inhaled corticosteroids in COPD: a systematic review of real-world findings. Expert Review of Clinical Pharmacology 13:9, pages 977-990.
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Wen-Chien Cheng, Biing-Ru Wu, Wei-Chih Liao, Chih-Yu Chen, Wei-Chun Chen, Te-Chun Hsia, Chih-Yen Tu, Chia-Hung Chen & Wu-Huei Hsu. (2020) When to Use Initial Triple Therapy in COPD: Adding a LAMA to ICS/LABA by Clinically Important Deterioration Assessment. International Journal of Chronic Obstructive Pulmonary Disease 15, pages 3375-3384.
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Jennifer K Quint, Alessandra Venerus, Caroline O’Leary, Melissa Myland, Ulf Holmgren, Precil Varghese & Claudia Cabrera. (2020) Prescribing Pathways to Triple Therapy: A Retrospective Observational Study of Adults with Chronic Obstructive Pulmonary Disease in the UK. International Journal of Chronic Obstructive Pulmonary Disease 15, pages 3261-3271.
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Anna Jetske Baron, Bertine M J Flokstra-de Blok, Ellen van Heijst, Roland A Riemersma, Agnes M M Sonnenschein-van der Voort, Esther I Metting & Janwillem W H Kocks. (2020) Prevalence of Asthma Characteristics in COPD Patients in a Dutch Well-Established Asthma/COPD Service for Primary Care. International Journal of Chronic Obstructive Pulmonary Disease 15, pages 1601-1611.
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Johanna Sulku, Christer Janson, Håkan Melhus, Andrei Malinovschi, Björn Ställberg, Kristina Bröms, Marieann Högman, Karin Lisspers, Margareta Hammarlund-Udenaes & Elisabet I Nielsen. (2019) A Cross-Sectional Study Assessing Appropriateness Of Inhaled Corticosteroid Treatment In Primary And Secondary Care Patients With COPD In Sweden. International Journal of Chronic Obstructive Pulmonary Disease 14, pages 2451-2460.
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Claudio Micheletto, Fulvio Braido, Marco Contoli, Fabiano Di Marco & Pierachille Santus. (2019) A Framework For Step Down Or Therapeutic Re-Organization For Withdrawal Of Inhaled Corticosteroids In Selected Patients With COPD: A Proposal For COPD Management. International Journal of Chronic Obstructive Pulmonary Disease 14, pages 2185-2193.
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Sergey Avdeev, Zaurbek Aisanov, Vladimir Arkhipov, Andrey Belevskiy, Igor Leshchenko, Svetlana Ovcharenko, Evgeny Shmelev & Marc Miravitlles. (2019) Withdrawal of inhaled corticosteroids in COPD patients: rationale and algorithms. International Journal of Chronic Obstructive Pulmonary Disease 14, pages 1267-1280.
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Maria Gabriella Matera, Luigino Calzetta, Ermanno Puxeddu, Paola Rogliani & Mario Cazzola. (2018) A safety comparison of LABA+LAMA vs LABA+ICS combination therapy for COPD. Expert Opinion on Drug Safety 17:5, pages 509-517.
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Didier Cataldo, Eric Derom, Giuseppe Liistro, Eric Marchand, Vincent Ninane, Rudi Peché, Hans Slabbynck, Walter Vincken & Wim Janssens. (2018) Overuse of inhaled corticosteroids in COPD: five questions for withdrawal in daily practice. International Journal of Chronic Obstructive Pulmonary Disease 13, pages 2089-2099.
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Jee Youn Oh, Young Seok Lee, Kyung Hoon Min, Gyu Young Hur, Sung Yong Lee, Kyung Ho Kang, Chin Kook Rhee, Seoung Ju Park, Adnan Khan, Jinhyuk Na, Youngja H Park & Jae Jeong Shim. (2018) Increased urinary l-histidine in patients with asthma–COPD overlap: a pilot study. International Journal of Chronic Obstructive Pulmonary Disease 13, pages 1809-1818.
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John R Hurst, Maria Dilleen, Kevin Morris, Siân Hills, Birol Emir & Rupert Jones. (2018) Factors influencing treatment escalation from long-acting muscarinic antagonist monotherapy to triple therapy in patients with COPD: a retrospective THIN-database analysis. International Journal of Chronic Obstructive Pulmonary Disease 13, pages 781-792.
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Amnon Ariel, Alan Altraja, Andrey Belevskiy, Piotr W Boros, Edvardas Danila, Matjaz Fležar, Vladimir Koblizek, Zvi G Fridlender, Kosta Kostov, Alvils Krams, Branislava Milenkovic, Attila Somfay, Ruzena Tkacova, Neven Tudoric, Ruxandra Ulmeanu & Arschang Valipour. (2018) Inhaled therapies in patients with moderate COPD in clinical practice: current thinking. International Journal of Chronic Obstructive Pulmonary Disease 13, pages 45-56.
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Peter M. A. Calverley, Helgo Magnussen, Marc Miravitlles & Jadwiga A. Wedzicha. (2017) Triple Therapy in COPD: What We Know and What We Don't. COPD: Journal of Chronic Obstructive Pulmonary Disease 14:6, pages 648-662.
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Marco Contoli, Angelo G. Corsico, Pierachille Santus, Fabiano Di Marco, Fulvio Braido, Paola Rogliani, Luigi Calzetta & Nicola Scichilone. (2017) Use of ICS in COPD: From Blockbuster Medicine to Precision Medicine. COPD: Journal of Chronic Obstructive Pulmonary Disease 14:6, pages 641-647.
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Articles from other publishers (25)

Janwillem Kocks, António Jorge Ferreira, Per Bakke, Onno C. P. van Schayck, Heikki Ekroos, Nikolaos Tzanakis, Stéphane Soulard, Monika Haaksma-Herczegh, Montserrat Mestres-Simon, Malena Águila-Fuentes & Didier Cataldo. (2023) Investigating the rationale for COPD maintenance therapy prescription across Europe, findings from a multi-country study. npj Primary Care Respiratory Medicine 33:1.
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Smit Patel, Scott Dickinson, Kevin Morris, Helen F. Ashdown & James D. Chalmers. (2022) A descriptive cohort study of withdrawal from inhaled corticosteroids in COPD patients. npj Primary Care Respiratory Medicine 32:1.
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Helgo Magnussen, Sarah Lucas, Therese Lapperre, Jennifer K. Quint, Ronald J. Dandurand, Nicolas Roche, Alberto Papi, David Price & Marc Miravitlles. (2021) Withdrawal of inhaled corticosteroids versus continuation of triple therapy in patients with COPD in real life: observational comparative effectiveness study. Respiratory Research 22:1.
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M. Zysman, B. Ribeiro Baptista, T. Soumagne, V. Marques da Silva, C. Martin, C. Thibault de Menonville, L. Boyer, B. Degano, C. Morelot Panzini, P.R. Burgel, T. Perez, A. Bourdin, C. Raherison, H. Pégliasco, D. Piperno, C. Zanetti, H. Morel, B. Delclaux, C. Delafosse, A. Lorenzo, B. Housset, F. Chabot, P. Devillier, G. Deslée & N. Roche. (2021) Optimisation du traitement médicamenteux des patients atteints de BPCO en état stable. Position de la Société de pneumologie de langue française. Actualisation 2021. Revue des Maladies Respiratoires 38:5, pages 539-561.
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Lisette van den Bemt, Lotte van den Nieuwenhof, Anne Rutjes, Victor van der Meer, Gerben Stege, Michel Wensing, Martina Teichert & Tjard Schermer. (2020) Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice. npj Primary Care Respiratory Medicine 30:1.
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James N. Cole, Rohini A. Mathur & Sally A. Hull. (2020) Reducing the use of inhaled corticosteroids in mild-moderate COPD: an observational study in east London. npj Primary Care Respiratory Medicine 30:1.
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James D. Chalmers, Irena F. Laska, Frits M.E. Franssen, Wim Janssens, Ian Pavord, David Rigau, Melissa J. McDonnell, Nicolas Roche, Don D. Sin, Daiana Stolz, Samy Suissa, Jadwiga Wedzicha & Marc Miravitlles. (2020) Withdrawal of inhaled corticosteroids in COPD: a European Respiratory Society guideline. European Respiratory Journal 55:6, pages 2000351.
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Sue Langham, Jen Lewis, Nick Pooley, Nina Embleton, Julia Langham, MeiLan K. Han & James D. Chalmers. (2019) Single-inhaler triple therapy in patients with chronic obstructive pulmonary disease: a systematic review. Respiratory Research 20:1.
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Pierachille Santus, Matteo Pecchiari, Francesco Tursi, Vincenzo Valenti, Marina Saad & Dejan Radovanovic. (2019) The Airways’ Mechanical Stress in Lung Disease: Implications for COPD Pathophysiology and Treatment Evaluation. Canadian Respiratory Journal 2019, pages 1-8.
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N. Pires, P. Pinto, N. Marçal, A.J. Ferreira, C. Rodrigues & C. Bárbara. (2019) Pharmacological treatment of COPD – New evidence. Pulmonology 25:2, pages 90-96.
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Maja Koraćević, Jelena Lalić, Sonja Nedeljković & Goran Koraćević. (2018) REBOUND PHENOMENON – IMPORTANT AND UBIQUITOUS IN PHARMACOTHERAPY. Acta Medica Medianae 57:4, pages 148-152.
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Linda Dawson. (2018) The controlled withdrawal of inhaled corticosteroids in patients with stable COPD in primary care. Nurse Prescribing 16:12, pages 610-615.
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Yao-Kuang Wu, Wen-Lin Su, Chun-Yao Huang, Mei-Chen Yang, Sin-Yi Chen & Chou-Chin Lan. (2018) Treatment of chronic obstructive pulmonary disease in patients with different fractional exhaled nitric oxide levels. Medicine 97:47, pages e11922.
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Han-Rong Feng, Chao Zhang & Song-Min Ying. (2018) Classical and Emerging Therapies against Chronic Obstructive Pulmonary Disease. Chinese Medical Journal 131:16, pages 1894-1897.
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S. N. Avdeev, A. S. Belevskiy, Z. R. Aisanov, V. V. Arkhipov, I. V. Leshchenko, S. I. Ovcharenko, A. I. Sinopal’nikov, A. A. Vizel’, A. V. Emel’yanov, A. V. Zhestkov, K. A. Zykov, N. A. Kuzubova, G. G. Prozorova, B. A. Chernyak, N. L. Shaporova & E. I. Shmelev. (2018) Possibilities to prevent acute exacerbation of chronic obstructive pulmonary disease using inhalational therapy. A Report of Expert Panel of Russian Respiratory Society. Russian Pulmonology 28:3, pages 368-380.
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Marc Miravitlles, Borja G. Cosío, Aurelio Arnedillo, Myriam Calle, Bernardino Alcázar-Navarrete, Cruz González, Cristóbal Esteban, Juan Antonio Trigueros, José Miguel Rodríguez González-Moro, José Antonio Quintano Jiménez & Adolfo Baloira. (2017) A proposal for the withdrawal of inhaled corticosteroids in the clinical practice of chronic obstructive pulmonary disease. Respiratory Research 18:1.
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Manuel Suarez-Barcelo, Joseph L. Micca, Sharon Clackum & Gary T. Ferguson. (2017) Chronic obstructive pulmonary disease in the long-term care setting. Current Opinion in Pulmonary Medicine 23:Supplement 1, pages S1-S28.
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Alan Kaplan, Suzanne Levitz & Kristine Petrasko. (2017) The role of spirometry in the management of obstructive airways disease: How pharmacists should get involved. Canadian Pharmacists Journal / Revue des Pharmaciens du Canada 150:4, pages 229-232.
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James D. Chalmers, Abigail Tebboth, Alicia Gayle, Andrew Ternouth & Nick Ramscar. (2017) Determinants of initial inhaled corticosteroid use in patients with GOLD A/B COPD: a retrospective study of UK general practice. npj Primary Care Respiratory Medicine 27:1.
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S. I. Ovcharenko, A. A. Vizel', I. V. Gamova, I. S. Dobrotina, Sh. Z. Zagidullin, V. I. Kupaev, N. G. Nedashkovskaya, L. B. Postnikova, O. P. Ukhanova, R. S. Fassakhov & R. F. Khamitov. (2017) A role of budesonide/formoterol fixed combination in the treatment of stable chronic obstructive pulmonary disease. A conclusion of the Expert Council of the Volga Federal district of Russia. PULMONOLOGIYA 27:1, pages 114-121.
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S. N. Avdeev, Z. R. Aisanov, A. S. Belevskiy, A. A. Vizel', S. K. Zyryanov, G. L. Ignatova, N. P. Knyazheskaya, I. V. Leshchenko, S. I. Ovcharenko, A. I. Sinopal'nikov, I. E. Stepanyan & V. I. Trofimov. (2017) New opportunities for prevention of exacerbations of chronic obstructive pulmonary disease. Russian Respiratory Society Expert Opinion. PULMONOLOGIYA 27:1, pages 108-113.
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Neven Tudoric, Vladimir Koblizek, Marc Miravitlles, Arschang Valipour, Branislava Milenkovic, Adam Barczyk, Attila Somfay, Kirill Zykov, Kosta Kostov, Zuzana Zbozinkova, Michal Svoboda, Jurij Sorli, Alvils Krams & Ruzena Tkacova. (2017) GOLD 2017 on the way to a phenotypic approach? Analysis from the Phenotypes of COPD in Central and Eastern Europe (POPE) Cohort. European Respiratory Journal 49:4, pages 1602518.
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S. N. Avdeev. (2016) PREVENTION OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. PULMONOLOGIYA 26:5, pages 591-603.
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Alexander I. Sinopal’nikov, I. V. Leshenko & K. Kostikas. (2016) The possibilities and limits of modern bronchodilating therapy for COPD. Clinical Medicine (Russian Journal) 94:6, pages 418-427.
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S. N. Avdeev, Z. R. Aysanov, A. S. Belevskiy, A. A. Vizel'G. L. Ignatova, N. P. Knyazheskaya, I. V. Leshchenko, S. I. Ovcharenko, V. I. TrofimovE. I. Shmelev. (2016) Perspectives of pharmacological therapy of chronic obstructive pulmonary disease: opportunities of dual bronchodilation and a role of inhaled steroids. Expert Council Consensus. PULMONOLOGIYA 26:1, pages 65-72.
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