Inhaled Corticosteroids and Chronic Obstructive Pulmonary Disease: Are We Barking Up the Wrong Tracheobronchial Tree?
Authors: Paul E. Epstein
Journal: Annals of Internal Medicine (2003)

Editorials17 June 2003Inhaled Corticosteroids and Chronic Obstructive Pulmonary Disease: Are We Barking Up the Wrong Tracheobronchial Tree?Paul E. Epstein, MD, Deputy EditorPaul E. Epstein, MD, Deputy EditorSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-12-200306170-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In many ways, chronic obstructive pulmonary disease (COPD) has already revealed its most terrible truths. Its causes are well recognized, its clinical course has been clearly described, and the means to its prevention are hardly in doubt but difficult to achieve. Despite our familiarity with COPD, it remains among the most common and most fatal diseases in the world. At last count, COPD affected more than 16 million Americans and ranked fourth among the leading causes of death in the United States (1). Still, its persistent mystery is unnerving. Treatment, although unsatisfactory, is expensive in terms of cost as well ...References1. Hurd S. The impact of COPD on lung health worldwide: epidemiology and incidence. Chest. 2000;117:1S-4S. [PMID: 10673465] CrossrefMedlineGoogle Scholar2. Callahan CM, Dittus RS, Katz BP. Oral corticosteroid therapy for patients with stable chronic obstructive pulmonary disease. A meta-analysis. Ann Intern Med. 1991;114:216-23. [PMID: 1824614] LinkGoogle Scholar3. Davies L, Nisar M, Pearson MG, Costello RW, Earis JE, Calverley PM. Oral corticosteroid trials in the management of stable chronic obstructive pulmonary disease. QJM. 1999;92:395-400. [PMID: 10627889] CrossrefMedlineGoogle Scholar4. Burge PS, Calverley PM, Jones PW, Spencer S, Anderson JA, Maslen TK. Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. BMJ. 2000;320:1297-303. [PMID: 10807619] CrossrefMedlineGoogle Scholar5. Highland KB, Strange C, Hefner JE. Long-term effects of inhaled corticosteroids on FEV1 in patients with chronic obstructive pulmonary disease. A meta-analysis. Ann Intern Med. 2003;138:969-73. LinkGoogle Scholar6. Sin DD, Tu JV. Inhaled corticosteroids and the risk of mortality and readmission in elderly patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;164:580-4. [PMID: 11520719] CrossrefMedlineGoogle Scholar7. Garcia-Aymerich J, Monso E, Marrades RM, Escarrabill J, Felez MA, Sunyer J, . Risk factors for hospitalization for a chronic obstructive pulmonary disease exacerbation. EFRAM study. Am J Respir Crit Care Med. 2001;164:1002-7. [PMID: 11587986] CrossrefMedlineGoogle Scholar8. Barnes PJ. New concepts in chronic obstructive pulmonary disease. Annu Rev Med. 2003;54:113-29. [PMID: 12359824] CrossrefMedlineGoogle Scholar9. Saetta M, Turato G, Maestrelli P, Mapp CE, Fabbri LM. Cellular and structural bases of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;163:1304-9. [PMID: 11371392] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Corresponding Author: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLong-Term Effects of Inhaled Corticosteroids on FEV1 in Patients with Chronic Obstructive Pulmonary Disease Kristin B. Highland , Charlie Strange , and John E. Heffner Metrics Cited byInhaled corticosteroids for stable chronic obstructive pulmonary diseaseInhaled corticosteroids for stable chronic obstructive pulmonary diseaseBroncopneumopatia cronica ostruttiva (BPCO)Sputum tests in the diagnosis and monitoring of asthmaCorticosteroids do not slow COPD progression 17 June 2003Volume 138, Issue 12Page: 1001-1002KeywordsAsthmaCellsChronic obstructive pulmonary diseaseCorticosteroid therapyCytotoxic T cellsForced expiratory volume in the first second of expirationInflammationLungsNeutrophilsSafety ePublished: 17 June 2003 Issue Published: 17 June 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...