Steroids May Be Overrated in Treatment of COPD

But experts disagree over whether to continue using them or not

By Steven Reinberg
HealthDay Reporter

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THURSDAY, Feb. 4 (HealthDay News) -- Patients suffering from chronic obstructive pulmonary disease (COPD) are often given inhaled corticosteroids to help ease exacerbations of the disease, but a new study finds these drugs may be of only limited benefit.

While inhaled corticosteroids have been widely prescribed to help treat the symptoms of COPD, they have also been linked to an increased risk of pneumonia, the researchers note.

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"I think the study is important and shows that the benefits of addition of inhaled corticosteroids to long-acting beta agonist formulations are only minimal compared to significant risks of pneumonia," said Dr. Sonal Singh, an assistant professor of medicine at Johns Hopkins University, who was not involved in the study.

"Unfortunately, therapeutic options for patients with COPD are limited and carry their own risks such as cardiovascular risks with anticholinergics," he added. "Thus a regulatory reassessment of the safety of COPD inhalers is needed."

COPD is an incurable condition that progressively destroys the lungs. While there is no cure, various medications can help treat the symptoms, including inhaled corticosteroids, long-acting beta agonists such as Serevent, short-acting beta agonists such as albuterol, and anticholinergics such as Spiriva.

Singh noted that while inhaled corticosteroids don't seem to add much to the treatment of COPD, long-acting beta agonists are not approved for use without them. "It's a real catch-22. It's not clear that there are any benefits and we know that the harms are substantial," Singh said.

"I sometimes use inhaled corticosteroids, but it's becoming less and less," he added.

The report is published in the February issue of the journal Chest.

For the study, Dr. Ritesh Agarwal and colleagues from the department of pulmonary medicine at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, looked at 11 studies that compared inhaled corticosteroids with placebos in some 8,164 COPD patients.

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