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Editorials |

Inhaled Steroids and Outcomes in COPD: Progressing Beyond FEV1

E. Rand Sutherland, MD, MPH, FCCP
Author and Funding Information

Affiliations: Denver, CO ,  Dr. Sutherland is Assistant Professor of Medicine, National Jewish Medical and Research Center.

Correspondence to: E. Rand Sutherland, MD, MPH, FCCP, Assistant Professor of Medicine, National Jewish Medical & Research Center, 1400 Jackson St, J220, Denver, CO 80206; e-mail: sutherlande@njc.org



Chest. 2007;131(3):648-649. doi:10.1378/chest.06-2823
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International guidelines1 recommend the addition of inhaled corticosteroids to inhaled bronchodilators for the treatment of patients with COPD who have a FEV1 < 50% of predicted normal and who experience exacerbations at least once per year. This recommendation has driven aggressive use of inhaled steroids in COPD, with published series suggesting that upwards of 50% of patients with COPD receive at least one prescription for inhaled corticosteroids, independent of FEV1 or exacerbation frequency. While the widespread use of these drugs would suggest that a clear understanding of their benefit exists, unresolved questions remain for the clinician trying to understand the most appropriate clinical outcomes for assessing response in treated patients, as well as the mechanisms by which any beneficial effects might occur.

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