[Effectiveness of inhaled corticosteroids in chronic obstructive lung disease: systematic review].
BACKGROUND
Inhaled corticosteroids are increasingly being used in patients with chronic obstructive lung disease (COPD), but their effectiveness is disputed. The aim of this study was to define the clinical effectiveness of inhaled corticosteroids in non-asthmatic COPD by a systematic review of the literature.


METHODS
Literature searches were conducted in Medline, the Cochrane library and the Spanish Medical Index. Only placebo-controlled trials were included. All trials were reviewed by two authors and data were extracted in a pre-defined manner. Meta-analytic techniques were used to estimate global effects when data were comparable.


RESULTS
No clinical trials on the role of inhaled corticosteroids during COPD exacerbations were found. Twelve studies on patients under a stable condition were identified and included in the review. Short-term studies showed that inhaled corticosteroids induced a small increase in FEV1 (average: 96 ml after 1-6 months). Longer term studies indicated that after 1-3 years of continued therapy, FEV1 was higher in treated than in control patients, but the difference was small (51 ml, CI 3-98). There were no consistent effects on symptom scores or the frequency of exacerbations.


CONCLUSIONS
The results of this review do not support the systematic use of inhaled corticosteroids in patients with non-asthmatic COPD.
Riancho
José A
JA
Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain. rianchoj@unican.es
Cubián
Ignacio
I
Portero
Isabel
I
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones