Inhaled corticosteroids in chronic obstructive pulmonary disease: a review

Expert Opin Pharmacother. 2010 Feb;11(3):405-21. doi: 10.1517/14656560903510628.


Importance of the field: Chronic obstructive pulmonary disease (COPD) is a disease characterized by chronic airflow obstruction and a progressive lung function decline. Although widely used, the efficacy of inhaled corticosteroids (ICS) in the treatment of COPD remains a matter of debate.

Areas covered in this review: This article reviews the evidence about the effects of inhaled corticosteroids in the treatment of COPD.

What the reader will gain: Short-term treatment with ICS improves lung function and quality of life; in addition, several studies with longer follow-up have shown less decline over time in quality of life, and fewer exacerbations. By contrast, long-term studies have been unable to show substantial improvement in the decline of lung function in COPD. Based on these findings, it was concluded that the use of ICS did not influence the natural course of COPD. However, this conclusion has been challenged by two subsequent studies, TORCH and GLUCOLD, which both showed a reduction in lung-function decline over time with the use of ICS. These two studies indicate that ICS might indeed influence the natural course of the disease, at least in a subgroup of COPD patients.

Take home message: Further studies are needed to identify which individuals have a favorable short- and long-term response to ICS treatment.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Asthmatic Agents / adverse effects
  • Anti-Asthmatic Agents / therapeutic use*
  • Bronchial Hyperreactivity / diagnosis
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / therapeutic use*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Health Status
  • Humans
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Respiratory Function Tests
  • Severity of Illness Index
  • Smoking / adverse effects
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents
  • Bronchodilator Agents