Video Experimental Relacionado
Updated: May 8, 2026
07:28
Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System
Published on: April 6, 2017
Corticosteroides inhalados en pacientes con enfermedad pulmonar obstructiva crónica estable: una revisión sistemática
M Bradley Drummond1, Elliott C Dasenbrook, Marshall W Pitz
1Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
JAMA
|November 27, 2008
Resumen
La terapia con corticosteroides inhalados (ICS) para la EPOC no afecta la mortalidad, pero aumenta el riesgo de neumonía. Se necesitan más investigaciones para identificar los subconjuntos de pacientes que pueden beneficiarse del tratamiento ICS.
Área de la Ciencia:
- Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
- Los ensayos clínicos son ensayos clínicos.
- Farmacología Farmacología.
Sus antecedentes:
- Existen pruebas contradictorias con respecto a la eficacia y seguridad de la terapia con corticosteroides inhalados (ICS) para la enfermedad pulmonar obstructiva crónica (EPOC) estable.
- Las preocupaciones incluyen posibles efectos en la supervivencia y el riesgo de eventos adversos.
Objetivo del estudio:
- Revisar sistemáticamente y sintetizar cuantitativamente el impacto de la terapia ICS en la mortalidad y los eventos adversos en pacientes con EPOC estable.
- Proporcionar un metanálisis exhaustivo de los ensayos controlados aleatorios existentes.
Principales métodos:
- Búsqueda exhaustiva de la literatura a través de varias bases de datos (MEDLINE, CENTRAL, EMBASE, etc.) para obtener más información. hasta febrero de 2008.
- Inclusión de ensayos controlados aleatorizados y doble ciego (ECA) de terapia ICS (≥6 meses) versus terapia no esteroideada en pacientes con EPOC.
- La abstracción de datos se centró en las características del estudio, la mortalidad por cualquier causa, la neumonía y las fracturas óseas, con un metanálisis utilizando modelos de efectos aleatorios o fijos basados en la heterogeneidad.
Principales resultados:
- Se analizaron once ECA en los que participaron 14.426 participantes.
- No se observó ninguna diferencia significativa en la mortalidad por cualquier causa a 1 año entre los grupos de ICS y de control (RR, 0.86; IC del 95%, 0.68-1.09).
- La terapia ICS se asoció con una incidencia significativamente mayor de neumonía (RR, 1.34; IC del 95%, 1.03-1.75), particularmente con dosis más altas, duración más corta, menor función pulmonar basal y terapia combinada.
Conclusiones:
- La terapia con corticosteroides inhalados no influye en la mortalidad por cualquier causa a 1 año en pacientes con EPOC.
- Un aumento notable en el riesgo de neumonía está relacionado con el uso de ICS en el manejo de la EPOC.
- Se requiere más investigación para identificar subgrupos específicos de pacientes con EPOC que pueden beneficiarse de la terapia ICS.
Videos de Conceptos Relacionados
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
01:26COPD: Management Using Bronchodilators and Corticosteroids
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
01:24Chronic Obstructive Pulmonary Disease
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
01:29Chronic Obstructive Pulmonary Disease-V: Management
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
01:23Inhaled Medications
Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...