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Editorials |

To Add, or Not To Add an Inhaled Corticosteroid in Moderate COPD : That Is the Question

Mario Cazzola, MD, FCCP; Maria Gabriella Matera, MD, PhD
Author and Funding Information

Affiliations: Rome, Italy,  Naples, Italy

Correspondence to: Mario Cazzola, MD, FCCP, Dipartimento di Medicina Interna, Università di Roma ‘Tor Vergata,’ Via Montpellier 1, 00133 Roma, Italy; e-mail: mario.cazzola@uniroma2.it



Chest. 2008;134(2):223-225. doi:10.1378/chest.08-0855
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The results of the Toward a Revolution in COPD Health (TORCH) study1 raise the fundamental question of when it is appropriate to add an inhaled corticosteroid (ICS) to a long-acting β-agonist (LABA) for treating a patient with COPD. The current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines2 recommend that an ICS be added to bronchodilator therapy for COPD patients at stages III (severe) and IV (very severe), who are those with an FEV1/FVC ratio < 0.70 and an FEV1 < 50% of predicted still having exacerbations. However, the results of the TORCH study,1 indicate the potential to also treat all symptomatic patients who present FEV1 between 50% and 60% of predicted; and, in effect, the recent extension of the salmeterol/fluticasone combination (SFC) license by European regulators,3 supports this notion.

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