Chronic obstructive pulmonary disease: chronic treatment with inhaled corticosteroids
DISEASE INTERVENTION COMPARISON RESULTS
Thorax. 2013 Nov;68(11):1029-36 Cohorts
IN chronic obstructive pulmonary disease The Use of
inhaled corticosteroids, specially fluticasone, less budesonide
As Treatment, Chronic
Is worse Than
no inhaled corticosterois
To carry an increased risk of severe pneumonia (causing hospitalization or death) : RR 2.0 for fluticasone, 1.2 with budesonide
Chest. 2010 Feb;137(2):318-25 Meta-Analysis
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is better Than
placebo
To modestly reduce exacerbations rate (RR 0.82) across all levels of severity.
JAMA. 2008 Nov 26;300(20):2407-16 Meta-Analysis
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is equal Than
placebo
To reduce overall mortality at 1 year (RR 0.86). Inhaled corticoids increased pneumonia rate (RR 1.34).
Thorax. 2003 Nov;58(11):937-41 Meta-Analysis
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is better Than
placebo
To reduce the rate of FEV1 decline (mean reduction 7.7 ml/year, and with high dose regimens 9.9 ml/year)
N Engl J Med. 1999 Jun 24;340(25):1948-53 Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is better Than
placebo
To reduce the rate of decline of post-bronchodilator FEV1 in the first 6 monts of treatment but but does not appreciably affect the long-term progressive decline.
Lancet. 1999 May 29;353(9167):1819-23 Randomized Controlled Trial
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is equal Than
placebo
To reduce the rate of decline in FEV1, reduce exacerbations or improve symptoms at 3 years.
Lancet. 1998 Mar 14;351(9105):773-80 Randomized Controlled Trial
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is better Than
placebo
To reduce excerbation rate at 6 months (32% in intv. VS 37% in ctrl.) and increase FEV1, symptoms and 6 min walking distance
Cochrane Database Syst Rev. 2007;(2):CD002991 Systematic Review, Cochrane Review
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is better Than
placebo
To temporarily (first 6 months) reduce the decline of FEV1 and reduce at long term rate of exacerbations (-0.26 /patient/year)
Chest. 2007 Mar;131(3):682-9 Meta-Analysis
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is better Than
placebo
To increase, at 6 months, FEV1 (mean of 42 mL in men and 29 mL in women compared with placebo) and keep this difference afterwards
BMJ. 2000 13 May;320(7245):1297-1303 Randomized Controlled Trial
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled
As Treatment, Chronic
Is better Than
placebo
To reduce excerbation rate (0,99/year in intv. VS 1,32/year in ctrl.) and produce a small increase in FEV1. But it did not affect the rate of decline in FEV1
N Engl J Med. 2007 Feb 22;356(8):775-89 Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable The Use of
corticosteroids, inhaled (fluticasone), alone or combined with inhaled long-acting beta2 agonists
As Treatment, Chronic
Is equal Than
placebo
To modify survival 3 years. There was a trend to better survival with combined inhaled corticosteroids plus lon-acting beta2 agonists but it did not reach sisnificance