[Inhaled steroids in COPD. Do they modify the disease?]

The use of inhaled steroids in the treatment of chronic obstructive lung disease is controversial. It is becoming ever more clear that a differentiated approach to treatment determined by the clinical presentation and the specific cell profile is needed. More inflammation, poorer lung function and more frequent exacerbation benefit from steroids, while early stages of the disease with few symptoms, and patients with predominance of emphysema but little bronchitis are unlikely to benefit from this form of treatment. Particular attention must be paid to mixed types with an asthma-like component. While the combination of long-acting beta-mimetic drugs and inhalative steroids might appear to be of benefit, the outcome of currently ongoing studies must be awaited.