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Steroids risks should be discussed with COPD patients

By Nigel Praities

GPs should discuss the potential risks of pneumonia, osteoporosis and adrenal suppression with all patients with COPD who might benefit from inhaled steroids, say NHS prescribing advisers.

A new bulletin recommends that GPs should look carefully at the risk-benefit of inhaled steroids for COPD following recent research linking the drugs with an increased risk of pneumonia.

It adds that GPs after another recent study finding anticholinergics were associated with an increased risk of all-cause and cardiovascular mortality should also be a factor in GPs' treatment decisions.

‘When decisions are made around treatment choices for patients with COPD, recent safety concerns, as well as the potential benefits of treatment, should feature along with response to treatment, potential side effects, patients' preference and cost,' the MeReC bulletin says.

The bulletin recommends GPs discuss the risk-benefit of inhaled corticosteroids, in particular, with patients.

‘Before adding an inhaled steroid to treatment regimens for patients with COPD, prescribers should consider, and discuss with patients, the potential increased risk of pneumonia, as well as osteoporosis and other side effects,' it reads.

Dr John Haughney, a GP in East Kilbride and member of the General Practice Airways Group, said GPs should wait for more definitive evidence of the risks of inhaled anticholinergics and steroids before alarming patients unnecessarily.

‘How can I explain this to a patient in a meaningful way? I think this guidance has been written to be truthful academically rather than to provide useful advice for GPs,' he said.

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