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.