Pharmacodynamics and pharmacokinetics of inhaled glucocorticoids
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2020, Clinics in Chest MedicineCitation Excerpt :Although no study has demonstrated an advantage to ICS-containing therapy with mortality as the primary endpoint, the weight of the evidence suggests that there may be a benefit in a subset of patients, likely those with more severe disease, significant symptoms, and exacerbation risk. Population-based studies and analyses of randomized controlled trials (RCTs) have shown that ICS therapy has untoward effects that include changes in bone density, oral candidiasis, insulin resistance, skin changes, and adrenal suppression as well as increased risk of pneumonia and mycobacterial infections (Table 1).49–56 COPD patients are at increased risk of community-acquired pneumonia as well as increased risk of death from pneumonia.57
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