What effect do inhaled steroids have on delaying the progression of COPD?
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The annual rate of decline in forced expiratory volume for 1 second (FEV1) has been researchers' gold standard as an objective measure for progression of chronic obstructive pulmonary disease (COPD). Inhaled corticosteroids (ICS) do not consistently have a statistically significant impact on FEV1 decline, and thus on the progression of COPD (strength of recommendation [SOR]: B, 2 conflicting meta-analyses and numerous conflicting randomized controlled trials). In those studies that did show improvements in FEV1 decline, the change does not appear to be clinically significant (7.7 to 9.0 mL/year). These findings do not take into account the potential impact of ICS on such patient oriented outcomes as exacerbation rates, quality of life, outpatient visits, hospitalization, and mortality.
Clinical Inquiries, 2004 (MU)
Journal of Family Practice, 53(10) 2004: 835-836.