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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)

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