[Treatment with inhalation corticosteroids: useful or useless in chronic obstructive pulmonary disease (COPD)?]

The effects of inhaled corticosteroids on lung function in chronic obstructive pulmonary disease (COPD) are small, particularly when compared with the effects in asthma. While there appears to be a positive effect on lung function, this is limited to the first few months of use. The clinical relevance of this is a minor delay in reaching a low (disabling) lung function level. Of more importance is probably the effect on the quality of life, the functional status (e.g. the 6-minute walking distance) and the number of exacerbations. In more severe COPD patients a clear gain in quality of life and decrease in exacerbations has been shown. So far, we must conclude that the use of inhaled corticosteroids in COPD may be useful. As soon as it is clear what other parameters than lung function make an adequate evaluation of a drug therapy possible, this interim conclusion can be given a firmer basis.