Long-Term Effects of Inhaled Corticosteroids on FEV1 in Patients with Chronic Obstructive Pulmonary Disease

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Abstract
There is no consensus on the effectiveness of inhaled corticosteroids for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the long-term effects of inhaled corticosteroids on the rate of FEV1 decline in patients with COPD. 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. Randomized, placebo-controlled trials that examined the rate of FEV1 decline as a primary outcome in patients with COPD. Two reviewers independently extracted the data by using predetermined criteria. 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). The use of inhaled corticosteroids was not associated with the rate of FEV1 decline in 3571 patients followed for 24 to 54 months.