Long-term effects of inhaled corticosteroids on FEV1 in patients with chronic obstructive pulmonary disease. A meta-analysis.
BACKGROUND
There is no consensus on the effectiveness of inhaled corticosteroids for the treatment of chronic obstructive pulmonary disease (COPD).


OBJECTIVE
To evaluate the long-term effects of inhaled corticosteroids on the rate of FEV1 decline in patients with COPD.


METHODS
MEDLINE, 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.


METHODS
Randomized, placebo-controlled trials that examined the rate of FEV1 decline as a primary outcome in patients with COPD.


METHODS
Two reviewers independently extracted the data by using predetermined criteria.


RESULTS
For 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).


CONCLUSIONS
The use of inhaled corticosteroids was not associated with the rate of FEV1 decline in 3571 patients followed for 24 to 54 months.
Highland
Kristin B
KB
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
Strange
Charlie
C
Heffner
John E
JE
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D005541:Forced Expiratory Volume / Q000187:drug effects*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D013147:Spirometry
D000305:Adrenal Cortex Hormones