Inhaled corticosteroids reduce exacerbations in chronic obstructive pulmonary disease

Inhaled corticosteroids have been widely used in the treatment of patients with chronic obstructive pulmonary disease, but there have been few trials to support this practice. Burge et al (p 1297) carried out a three year, double blind, randomised trial in patients with moderate to severe disease. They found that fluticasone propionate 1 mg daily significantly reduced the frequency of exacerbations and the rate of decline in health. There was no reduction in rate of decline of FEV₁, although FEV₁ was slightly higher with fluticasone than with placebo. The affect on acute exacerbations and impaired health status may explain why clinicians have used these drugs, even though FEV₁ is little influenced by them.

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Relevant Article

Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial

P S Burge, P M A Calverley, P W Jones, S Spencer, J A Anderson, and T K Maslen
BMJ 2000 320: 1297-1303. [Abstract] [Full Text] [PDF]