[The choice and administration of corticoids in COPD]

Although the role of steroid inhalations is well established for the chronic treatment of asthmatic patients, their use in the chronic treatment of patients with COPD remains controversial. Steroid inhalations do not prevent the yearly FEV1 decline, which is an important prognostic factor of the disease. Inhaled steroid are not indicated for the treatment of early disease. For the patient with advanced disease (FEV1 < 50% of the predicted value) and presenting several exacerbations each year, inhaled steroids reduce the number of exacerbations and slow the progressive decline of quality of life. There is no place for continued oral glucocorticoid treatment. For mixed conditions (COPD and asthma), inhaled steroid may be of value.