© 2003 BMJ Publishing Group Ltd & British Thoracic Society
EDITORIAL
Inhaled steroids in COPD
So inhaled steroids slow the rate of decline of FEV1 in patients with COPD after all?
1 Birmingham Heartlands Hospital, Birmingham, UK
2 Division of Respiratory Medicine, City Hospital, University of Nottingham, Nottingham, UK
Correspondence to:
Correspondence to:
Dr Sherwood Burge, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK;
sherwood.burge@heartsol.wmids.nhs.uk
Meta-analyses show that inhaled steroids are helpful in COPD
Keywords: meta-analysis; inhaled steroids; chronic obstructive pulmonary disease
| The first 150 words of the full text of this article appear below. |
The medical community has made up its mind that, although inhaled corticosteroids reduce exacerbations in patients with chronic obstructive pulmonary disease (COPD),1 they do not affect disease progression.2 Despite measurement of forced expiratory volume in one second (FEV1) being widely available and a strong predictor of mortality,3 the emphasis has moved to softer outcome measures which do show changes with available treatments. Ten years ago many of us had different beliefs—several small studies using simple statistics suggested that the rate of decline in FEV1 could be reduced by about 20 ml a year by inhaled corticosteroids.4–6 This led to several large studies, the primary outcome of which was decline in FEV1 and which were powered to detect a 20 ml/year difference between active and placebo treatments.7–10 All failed to show significant differences in their primary outcome of FEV1 decline between various inhaled corticosteroids and placebo.
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Thorax 2003 58: 911.[Extract] [Full Text] [PDF]
This article has been cited by other articles:
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Hahn, D L, Burge, P S, Lewis, S A
(2004). Ethics of placebo controlled studies of inhaled steroids for COPD * Authors' reply. Thorax
59: 539-540
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