PT - JOURNAL ARTICLE AU - D.D. Sin AU - S.F.P. Man TI - Inhaled corticosteroids and survival in chronic obstructive pulmonary disease: does the dose matter? AID - 10.1183/09031936.03.00040803 DP - 2003 Feb 01 TA - European Respiratory Journal PG - 260--266 VI - 21 IP - 2 4099 - http://erj.ersjournals.com/content/21/2/260.short 4100 - http://erj.ersjournals.com/content/21/2/260.full SO - Eur Respir J2003 Feb 01; 21 AB - Recent data suggest that inhaled corticosteroids reduce the number of clinical exacerbations in chronic obstructive pulmonary disease (COPD). It remains unknown whether a dose/response relationship exists. The present study was conducted to evaluate the long-term impact of varying doses of inhaled corticosteroids on COPD mortality. Hospital discharge data were used to identify all patients aged ≥65 yrs recently hospitalised due to COPD in Alberta, Canada (n=6,740). The relative risk (RR) for all-cause mortality was compared across different dose categories of inhaled corticosteroids (none and low, medium and high doses) following hospital discharge. Inhaled corticosteroid therapy after discharge was associated with a 25% relative reduction in risk for all-cause mortality (RR 0.75, 95% confidence interval (CI) 0.68–0.82). Patients on medium- or high-dose therapy showed lower risks for mortality than those on low doses (RR 0.77, 95% CI 0.69–0.86 for low dose; RR 0.48, 95% CI 0.37–0.63 for medium dose; and RR 0.55, 95% CI 0.44–0.69 for high dose). Use of inhaled corticosteroids following hospital discharge for chronic obstructive pulmonary disease was associated with a significant reduction in the overall mortality rate. Low- was inferior to medium- or high-dose therapy in protecting against mortality in chronic obstructive pulmonary disease. D.D. Sin is supported by a New Investigator Award from the Canadian Institutes of Health Research, Ottawa, Canada, and a Population Health Investigator Award from the Alberta Heritage Foundation for Medical Research, Edmonton, Canada.