• Kristin B Highland, Charlie Strange, and John E Heffner.
• Division of Pulmonary, Critical Care, Allergy and Clinical Immunology, Medical University of South Carolina, 96 Jonathan Lucas Street, 812 CSB, Box 250623, Charleston, South Carolina 29425, USA. highlakb@musc.edu
• Ann. Intern. Med. 2003 Jun 17; 138 (12): 969973969-73.

BackgroundThere is no consensus on the effectiveness of inhaled corticosteroids for the treatment of chronic obstructive pulmonary disease (COPD).PurposeTo evaluate the long-term effects of inhaled corticosteroids on the rate of FEV1 decline in patients with COPD.Data SourcesMEDLINE, EMBASE, CISCOM, and AMED databases and the Cochrane Library (1966 to December 2002), reference lists from identified articles, and consultation with experts. Searches were not limited to the English language.Study SelectionRandomized, placebo-controlled trials that examined the rate of FEV1 decline as a primary outcome in patients with COPD.Data ExtractionTwo reviewers independently extracted the data by using predetermined criteria.Data SynthesisFor the six studies that met the inclusion criteria, the summary estimate for the difference in FEV1 decline between the placebo and treatment groups was -5.0 +/- 3.2 mL/y (95% CI, -11.2 to 1.2 mL/y; P = 0.11).ConclusionsThe use of inhaled corticosteroids was not associated with the rate of FEV1 decline in 3571 patients followed for 24 to 54 months.

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