[Safety of inhaled corticosteroids in COPD]

Abstract

Inhaled corticosteroids (IC) are used in chronic obstructive pulmonary disease (COPD) as these agents decrease the frequency of exacerbations and halt the impairment in health-related quality of life. The intimate mechanisms supporting their use and the dose that should be employed have not been sufficiently well established. IC have adverse effects that are hardly described in guidelines for the management of COPD and are sometimes not even mentioned. These agents have been related to adverse effects in the upper airways, intraocular hypertension and glaucoma, loss of bone mass and fractures, adrenal suppression and, lately, with pneumonia. The debate on the role of CI in these processes is ongoing. However, given the growing frequency of the use of these drugs, awareness of their potential adverse effects is essential, especially since the pharmacodynamic characteristics of the distinct IC differ widely.