Discussion of interesting or befuddling cases related to pulmonary and critical care medicine.
Monday, November 28, 2005
ICS in COPD
This is a quick question. How often do you add inhaled steroids in the care of your COPD patients? I am more curious about people's anecdotal and personal opinions rather than data (FEV1< 30%, response to PO steroid trial, etc.).
I think there are two types of patients with COPD that I use ICS: 1. The person who has exacerbations (1 in the hospital in the last year or 2 at home with steroids in the last year) 2. Anyone with significant exercise intolerance.
Rehab usually helps fix #2, but I still think ICS offer some benefits.
I am anxious to hear other opinions on this really good question...
Perhaps another reason to use ICS... lower cardiovascular risk. Just an abstract, but interesting nonetheless.
Löfdahl CG, Postma D, Pride N, et al. Does inhaled budesonide protect against cardio-ischemic events in mild-moderate COPD a post-hoc evaluation of the EUROSCOP study. European Respiratory Journal, 2005;29 (Supplement 49): Abstract 2333.
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I think there are two types of patients with COPD that I use ICS:
1. The person who has exacerbations (1 in the hospital in the last year or 2 at home with steroids in the last year)
2. Anyone with significant exercise intolerance.
Rehab usually helps fix #2, but I still think ICS offer some benefits.
I am anxious to hear other opinions on this really good question...
Perhaps another reason to use ICS... lower cardiovascular risk. Just an abstract, but interesting nonetheless.
Löfdahl CG, Postma D, Pride N, et al. Does inhaled budesonide protect against cardio-ischemic events in mild-moderate COPD a post-hoc evaluation of the EUROSCOP study. European Respiratory Journal, 2005;29 (Supplement 49): Abstract 2333.
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