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High-dose inhaled corticosteroids (ICS) reduce the rate of exacerbations in severe and very severe chronic obstructive pulmonary disease (COPD) when prescribed with inhaled long-acting β-agonists (LABA).1 ,2 Although LABA+ICS use is now universally recommended for severe and very severe COPD, the magnitude of their effect is disputed and they are associated with a higher risk of pneumonia.3 Risk of pneumonia has been associated particularly with fluticasone propionate, and less clearly with budesonide.4 ,5 Equivalence of potency between different …
Competing interests None.