TREATMENT
Review: inhaled corticosteroids do not reduce mortality but increase pneumonia in chronic obstructive pulmonary disease
| The first 150 words of the full text of this article appear below. |
In patients with stable chronic obstructive pulmonary disease (COPD), what are the harms and benefits of inhaled corticosteroid (ICS) therapy?
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.
Medline, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and PsycINFO (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).
ICS therapy did not reduce mortality at any time
University of Buffalo, Buffalo, New York, USA
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Pneumonia (infectious disease)
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TB and other respiratory infections
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Drugs: respiratory system
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