Recurrent exacerbations in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) should be treated with inhaled corticosteroids, say European investigators. Their findings support treatment guidelines recommended in the Global Initiative for Chronic Obstructive Disease, which were issued jointly in 2001 by the World Health Organisation and the US National Heart, Lung, and Blood Institute. Reducing exacerbations improves health and decreases use of healthcare resources by COPD patients. A previous study, the Inhaled Steroids in Obstructive Lung Disease in Europe (ISOLDE), found the yearly rate of exacerbations was reduced by 26% in patients treated with fluticasone propionate compared to placebo.
However, it did not show which subjects showed greatest benefit, those with mild COPD or those with more severe disease. This study, from St George’s Hospital Medical School, London, UK, and other European institutions, examined 391 patients with mild COPD (195 of whom received fluticasone) and 359 with moderate-to-severe disease (180 of whom received fluticasone). COPD severity was gauged by FEV1 (forced expiratory volume in one second). In addition to severity, data were also collected on the total number of exacerbations as well as those episodes requiring treatment with oral corticosteroids.
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