TY - JOUR T1 - COPD: an inhaled corticosteroid-resistant, oral corticosteroid-responsive condition JF - European Respiratory Journal JO - Eur Respir J SP - 863 LP - 865 DO - 10.1183/09031936.06.00146705 VL - 27 IS - 4 AU - S. Saha AU - R. Siva AU - C. E. Brightling AU - I. D. Pavord Y1 - 2006/04/01 UR - http://erj.ersjournals.com/content/27/4/863.abstract N2 - To the Editors: Few areas of respiratory medicine have generated as much controversy as the use and purpose of long-term corticosteroid treatment in chronic obstructive pulmonary disease (COPD). However, several recent large, placebo-controlled studies have clarified the role of long-term treatment with inhaled corticosteroids 1–3. There is now consistent evidence that inhaled corticosteroid treatment, even in high doses, is not associated with a clinically significant reduction in the rate of decline of forced expiratory volume in one second (FEV1). Treatment is associated with a modest reduction in the frequency of more severe exacerbations, particularly in patients with more severe disease 1, 4 and in those who have a good bronchodilator response to short-term treatment with oral prednisolone 5, 6. The limited effects seen with inhaled corticosteroids is surprising, given that induced sputum evidence of corticosteroid-responsive eosinophilic airway inflammation is present in up to 40% of patients with stable moderate and severe COPD disease 7–10, … ER -