Key points for the use of anti-inflammatory agents

Long-term monotherapy with ICS is not recommended (evidence A)
Long-term treatment with ICS may be considered in association with LABAs for patients with a history of exacerbations despite appropriate treatment with long-acting bronchodilators (evidence A)
Long-term therapy with oral corticosteroids is not recommended (evidence A)
In patients with exacerbations despite LABA/ICS or LABA/LAMA/ICS, chronic bronchitis and severe to very severe airflow obstruction, the addition of a PDE4 inhibitor can be considered (evidence B)
In former smokers with exacerbations despite appropriate therapy, macrolides can be considered (evidence B)
Statin therapy is not recommended for prevention of exacerbations (evidence A)
Antioxidant mucolytics are recommended only in selected patients (evidence A)

ICS: inhaled corticosteroid; LABA: long-acting β2-agonist; LAMA: long-acting muscarinic antagonist; PDE: phosphodiesterase.