THERAPEUTICS
Review: inhaled corticosteroids do not reduce mortality but increase pneumonia in COPD
| The first 150 words of the full text of this article appear below. |
QUESTION
In patients with stable chronic obstructive pulmonary disease (COPD), what are the harms and benefits of inhaled corticosteroid (ICS) therapy?
REVIEW SCOPE
Included studies compared an ICS with placebo or other inhaled medications in patients 
40 years of age with stable COPD. Outcomes were all-cause mortality at 1 and 3 years, pneumonia, and fractures.
REVIEW METHODS
Medline, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and PsycINFO (all to Feb 2008); and references were searched for published, double-blind, randomised controlled trials (RCTs) with duration 6 months. 11 RCTs (14 comparisons, n = 14 426) met the selection criteria. 8 comparisons were placebo-controlled; most other trials compared an ICS plus a long-acting β2-agonist (LABA) with the LABA alone. 7 trials reported concealment of allocation, and all trials had blinding of outcome assessors. Mean study duration was 24 months (range 6–40 mo).
MAIN RESULTS
ICS therapy did not reduce mortality at any time
King’s College London School of Medicine London, UK
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