Long-term effects of inhaled corticosteroids on FEV1 in patients with chronic obstructive pulmonary disease. A meta-analysis

Ann Intern Med. 2003 Jun 17;138(12):969-73. doi: 10.7326/0003-4819-138-12-200306170-00008.


Background: There is no consensus on the effectiveness of inhaled corticosteroids for the treatment of chronic obstructive pulmonary disease (COPD).

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

Data sources: 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.

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

Data extraction: Two reviewers independently extracted the data by using predetermined criteria.

Data synthesis: 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.

Publication types

  • Meta-Analysis

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage*
  • Forced Expiratory Volume / drug effects*
  • Humans
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Randomized Controlled Trials as Topic
  • Spirometry


  • Adrenal Cortex Hormones