Combination of ICSs and LABAs Should Be Used in the Management of Patients with COPD -- The Pro Argument

THE EFFECTS OF INHALED CORTICOSTEROID MONOTHERAPY Airway inflammation is a prominent feature of chronic obstructive pulmonary disease (COPD), even among ex-smokers (1), and its intensity is directly related to the severity of the underlying COPD (2). The inflammatory burden increases during periods of clinical exacerbation (3-5). Predictably, use of systemic corticosteroids during these episodes accelerates clinical recovery and improves health outcomes over several months of follow-up (6). Unfortunately, long term use of systemic corticosteroids is generally precluded by their toxic side effects. Inhaled corticosteroids, on the other hand, share much of the anti-inflammatory properties of the systemic formulations without the side effects (7). However, their effectiveness has been questioned and is a matter of heated debate among members of the scientific community (8,9)